The release of polycyclic aromatic hydrocarbons (PAHs) by human energy exploitation and excessive environmental use has caused substantial environmental contamination. These compounds bioaccumulate in aquatic environments and translocate through the food chain, posing risks to health and environmental safety. To better understand the risks of PAHs in surface water and food chains, this review summarizes their distribution, concentration levels, sources, and toxicity in various surface water environments. It also examines how PAH bioaccumulation affects aquatic organisms and human health. Globally, PAHs have been detected in both aquatic environments and organisms with an increasing trend. Human activity is the main cause of PAH contamination. The results revealed a distinct geographical distribution of PAH risk influenced by population density, industrial development, climate, and seasonal variations. PAHs are found in remote areas, indicating their medium- and long-range transport by atmospheric dispersion. PAHs bioaccumulate in aquatic organisms and cause direct and indirect toxic effects via biomagnification. PAH bioaccumulation is directly correlated with aquatic pollution. This study also emphasizes the carcinogenicity of compounds such as benzo[a]pyrene, identifying occupational and environmental exposure frequencies as key risk factors. This study enhances our understanding of the dynamics of multiple PAHs in aquatic ecosystems and their health effects, thereby contributing to environmental sustainability.