Fruit juices are common products in modern diets due to the supply of vegetal nutrients combined with its tastiness. Nevertheless, potential contaminants, such as mycotoxins and pesticides, can be present in commercial products due to a potential carry-over. Therefore, the aim of this study was to investigate for the first time the presence of 14 Fusarium mycotoxins using a quick, easy, cheap, effective, rugged, and safe (QuEChERS)-based extraction followed by an ultra-high-performance liquid chromatography-quadrupole Orbitrap high-resolution mass spectrometry in 21 pear juice samples from Italian markets. Up to nine different mycotoxins were detected, particularly an extensive presence of zearalenone (67%, n = 21, mean value = 0.88 ng/mL). Emerging Fusarium mycotoxins enniatins B, B1, A, and A1 were also detected. Additionally, 77 pesticide residues were tentatively identified through a retrospective analysis based on a mass spectral library. The prevalent presence of some non-approved pesticides, such as ethoxyquin (64%, n = 21) and triazophos (55%, n = 21), must be highlighted. The results obtained indicate an extensive contamination of marketed pear juice with undesirable compounds, and they should be taken into consideration when performing risk assessment studies.