Antibiotic residues, their mixture toxicity, and the potential selection for antibiotic-resistant bacteria could pose a problem for water use and the ecosystem of reservoirs. This study aims to provide a comprehensive understanding of the occurrence, concentration, distribution, and ecological risks associated with various antibiotics in the Cirata reservoir, Indonesia. In our water and sediment samples, we detected 24 out of the 65 antibiotic residues analyzed, revealing a diverse range of antibiotic classes present. Notably, sulphonamides, diaminopyrimidine, and lincosamides were frequently found in the water, while the sediment predominantly contained tetracyclines and fluoroquinolones. Most antibiotic classes reached their highest concentrations in the water during the dry season. However, fluoroquinolones and tetracyclines showed their highest concentrations in the water during the wet season. Ecotoxicological risk assessments indicated that the impact of most antibiotic residues on aquatic organisms was negligible, except for fluoroquinolones. Looking at the impact on cyanobacteria, however, varying risks were indicated, ranging from medium to critical, with antibiotics like sulfamethoxazole, ciprofloxacin, norfloxacin, and lincomycin posing substantial threats. Among these, ciprofloxacin emerged as the antibiotic with the strongest risk. Furthermore, fluoroquinolones may have the potential to contribute to the selection of antibiotic-resistant bacteria. The presence of mixtures of antibiotic residues during the wet season significantly impacted species loss, with Potentially Affected Fraction of Species (msPAF) values exceeding 0.75 in almost 90% of locations. However, the impact of mixtures of antibiotic residues in sediment remained consistently low across all locations and seasons. Based on their occurrences and associated risks, 12 priority antibiotic residues were identified for monitoring in the reservoir and its tributaries. Moreover, the study suggests that river inflow serves as the most significant source of antibiotic residues in the reservoir. Further investigations into the relative share attribution of antibiotic sources in the reservoir is recommended to help identify effective interventions.