Carbamazepine, as one of several pharmaceutical and personal care products, has gained much attention in recent years because of its continuous discharge in natural waters and toxicity to aquatic ecosystems. However, it is difficult to evaluate and manage carbamazepine pollution because of the lack of a rational and scientific Water Quality Criteria (WQC) of carbamazepine. In this study, the carbamazepine toxicity data of thirty-five aquatic species from eight taxonomic groups were selected, and the species sensitivity distribution (SSD) method was applied to derive the WQC for carbamazepine based on the Log-logistic model, which was 18.4 ng/L. Meanwhile, the occurrence and distribution of carbamazepine in the Nansi Lake basin was studied. Results showed that concentrations of carbamazepine in 29 sampling sites were in the range of 3.3 to 128.2 ng/L, with the mean of 17.3 ng/L. In general, the levels of carbamazepine in tributaries were higher than those in the lakes. In addition, qualitative and quantitative ecological risk assessment methods were applied to assess the adverse effect of carbamazepine on aquatic systems. The hazard quotient (HQ) method showed that there were 24 and 5 sampling sites, in which risk levels were low and moderate, respectively. The joint probability curve (JPC) method indicated that ecological risks might exist in 1.4% and 1.0% of surface water, while a 5% threshold and 1% threshold were set up to protect aquatic species, respectively. Generally, carbamazepine posed a low risk to the aquatic organisms in the Nansi Lake basin.