Abstract This study analyzes the variation and risk changes of extreme precipitation under nonstationarity conditions using the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) and the Mann–Kendall (MK) test. The extreme precipitation series is extracted from the observations during the second flood season (July–September) from 1960 to 2012 derived from 86 meteorological stations in the southeastern coastal region of China. The trend of mean (Mn) and variance (Var) of extreme precipitation is detected by MK. Ten large-scale circulation variables and four greenhouse gases are selected to construct a climate change index and a human activity index, which are based on principal component analysis. The recurrence risk of extreme precipitation is calculated by GAMLSS while considering climate changes and human activities. The results demonstrate that the nonstationarity characteristic of extreme precipitation is widespread in this region. A significant increasing trend of Mn is found in Shanghai, eastern Zhejiang, and northern and southern Fujian. An enhanced Var is found in eastern Guangdong. A significant positive correlation exists between climate changes/human activities and Mn/Var, especially in Zhejiang and Fujian. Generally, the contribution of climate changes and human activities to Mn is greater than it is to Var. In this region, the precipitation amount of high-frequency (2-yr return period) and low-frequency (100-yr return period) events increases from inland to coastal and from north to south. The government should pay careful attention to these trends because the intensity of extreme precipitation events and their secondary disasters could result in serious losses.