The •OH and SO4•− play a vital role on degrading pharmaceutical contaminants in water. In this paper, theoretical calculations have been used to discuss the degradation mechanisms, kinetics and ecotoxicity of acetaminophen (AAP) initiated by •OH and SO4•−. Two significant reaction mechanisms of radical adduct formation (RAF) and formal hydrogen atom transfer (FHAT) were investigated deeply. The results showed that the RAF takes precedence over FHAT in both •OH and SO4•− with AAP reactions. The whole and branched rate constants were calculated in a suitable temperature range of 198–338 K and 1 atm by using the KiSThelP program. At 298 K and 1 atm, the total rate constants of •OH and SO4•− with AAP were 3.23 × 109 M−1 s−1 and 4.60 × 1010 M−1 s−1, respectively, considering the diffusion-limited effect. The chronic toxicity showed that the main degradation intermediates were harmless to three aquatic organism, namely, fish, daphnia, and green algae. From point of view of the acute toxicity, some degradation intermediates were still at harmful or toxic level. These results provide theoretical guidance on the practical degradation of AAP in the water.