The Loess Plateau has one of the most vulnerable ecological environments in the world, but it also contains abundant oil and gas resources that are regularly exploited, which has resulted in serious environmental problems. Therefore, it is important to analyze the polycyclic aromatic hydrocarbons (PAHs) present in the topsoil of this region. The ∑16PAHs concentrations between 1980–1999 and 2000–2019 ranged from 1134.20–15871.04 and 1010.67–18,068.80 µg kg−1, with average values of 5021.30 and 5662.82 µg kg−1. All samples displayed heavy pollution levels according to European soil quality standards. In addition, among the measured physicochemical properties, the soil organic carbon (SOC) had the greatest influence on PAHs, while soil particle size distribution had the smallest effect. Source apportionment indicated that the two main sources were petroleum source (37.57%) and vehicular traffic source (25.88%). Lastly, an assessment of the carcinogenic risks illustrated that more focus should be placed on the dermal pathway in which the human body is exposed to soil PAHs. Overall, the carcinogenic risks in different populations did not exceed 10−4, but there was still a potential carcinogenic risk in some age groups, especially in adult women.