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Septic tanks (STs) as a decentralised approach to community wastewater treatment were investigated as a pathway for emerging contaminants (ECs) entering the aquatic environment. A broad range of ECs were examined in five community STs (population equivalents 217–475) and receiving rivers in Scotland over 12 months. All 68 studied ECs were detected at least once in ST influent or effluent at a broad concentration range from ng L−1 – μg L−1 which can surpass freshwater predicted no-effect concentrations. Pharmaceuticals with acute use, such as antibiotics and antifungals, had high monthly variability and concentrations can exceed those previously found in centralised wastewater treatment works. Differences between the STs demonstrate the impact of localised prescription and population behaviour on EC concentrations. The similarities in concentrations between influent and effluent, suggest limited or no removal of ECs in STs. Hence, dilution of the discharges is required to mitigate environmental risk. Although the contribution of ECs sorbed to suspended solids to the total EC concentration was generally small (<10%), higher contributions (>30%) were observed for fluoroquinolone antibiotics (ofloxacin and ciprofloxacin), antidepressants (fluoxetine), and antifungals (clotrimazole). A wide range of ECs were also detected in rivers upstream and downstream of the ST discharge points, and concentrations increased by up to 95% downstream. In general, risk quotients (RQs) in the rivers were low, indicating small risk for the environment. However, higher RQs (>1) were found for ibuprofen, diclofenac and ciprofloxacin in a few samples. Therefore, reducing their concentration by improving ST performance or through sustainable medicines use may be needed at low dilution locations to mitigate any risk. [Display omitted] • Community septic tanks are a pathway for emerging contaminants entering rivers. • There is no or limited removal of emerging contaminants in community septic tanks. • Pharmaceuticals with acute use show high variability in wastewater. • Effluent concentrations can exceed those in centralised wastewater treatment works. • Medium or high environmental risk found for ibuprofen, diclofenac and ciprofloxacin. [ABSTRACT FROM AUTHOR]