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Chlorpyrifos has been used extensively for decades to control crop pests and disease-transmitting insects; its contribution to increasing food security and minimizing the spread of diseases has been well documented. Pymetrozine and Avermectin (also known as abamectin) have been used to replace the toxic organophosphate insecticides (e.g., Chlorpyrifos) applied to rice crops in China, where the overuse of pesticides has occurred. In addition, climate change has exacerbated pesticide use and pollution. Thus, farmers and communities are at risk of exposure to pesticide pollution. This study reviews the contamination, exposure, and health risks through environmental and biological monitoring of the legacy pesticide Chlorpyrifos and currently used insecticides Pymetrozine and Avermectin in China; it investigates whether changes in pesticide usage from Chlorpyrifos to Pymetrozine and Avermectin reduce pesticide contamination and health hazards to communities and residents. In addition, this review discusses whether Pymetrozine and Avermectin applications could be recommended in other countries where farmers largely use Chlorpyrifos and are exposed to high health risks under climate change scenarios. Although Chlorpyrifos is now banned in China, farmers and residents exposed to Chlorpyrifos are still experiencing adverse health effects. Local farmers still consider Chlorpyrifos an effective pesticide and continue to use it illegally in some areas. As a result, the concentration levels of Chlorpyrifos still exceed risk-based thresholds, and the occurrence of Chlorpyrifos with high toxicity in multiple environmental routes causes serious health effects owing to its long-term and wide application. The bioaccumulation of the currently used insecticides Pymetrozine and Avermectin in the environment is unlikely. Pymetrozine and Avermectin used in paddy water and soil for crop growth do not pose a significant hazard to public health. A change in pesticide use from Chlorpyrifos to Pymetrozine and Avermectin can reduce the pesticide contamination of the environment and health hazards to communities and residents. Finally, we recommend Pymetrozine and Avermectin in other countries, such as Vietnam, and countries in Africa, such as Ghana, where farmers still largely use Chlorpyrifos. [ABSTRACT FROM AUTHOR]