The occurrence and fate of pharmaceuticals and personal care products (PPCPs) was investigated in seven wastewater treatment plants (WWTPs) in Xiamen City, China. Special emphasis was placed on their co-occurrence and the mass balances of both dissolved and adsorbed PPCPs in influent, effluent, and sludge samples. Results showed that PPCPs were widely detected and their co-occurrence was observed both in the wastewater and sludge that can be attributed to either their similar usage or similar physicochemical properties. These results further emphasize that some specific PPCPs have the potential as indicators or surrogate compounds to reduce the number of targeted PPCPs. The occurrence and distribution of PPCPs also showed strong spatial variations, as the PPCP mass loads per inhabitant were positively correlated with the urbanization levels. Both the removal efficiencies of dissolved PPCPs from the aqueous phase and mass loss proportion of the total PPCPs were evaluated and compared. Overall, a measured total amount of 8500 g PPCPs entered the seven WWTPs daily via influent with 6640 g in the dissolved form, while 3450 g left the WWTPs. The large mass loads of antibiotics in the sludge and effluents indicated their potential adverse effects to the receiving environment.