Rare earth elements (REEs), known as “industrial vitamins”, are widely used in medical treatment, industry, agriculture, etc. However, with the increasing demand for REEs, excess REEs, such as gadolinium (Gd), are considered micropollutants in the environment. In this paper, the distributions of dissolved REEs were analyzed in three small streams, in order to determine the extent and occurrence of Gd anomalies. The shale-normalized REE patterns in the three streams were less smooth with heavy REEs higher than light REEs, for a weak reaction of the heavy REE complexes. A negative Ce (cerium) anomaly and positive samarium (Sm) and europium (Eu) anomalies were observed in the three streams and the negative Ce anomaly was affected by the pH of the alkaline rivers. However, a positive Gd anomaly was found in only a typical urban small stream, Jinzhong. With a population of approximately 60,000, Jinzhong runs by a hospital and through wastewater treatment plants (WWTPs). The concentrations of Gd in Jinzhong ranged from 1.54 to 86.65 ng/L with high anthropogenic Gd proportions (63.64%–98.07%). Anthropogenic Gd showed significant seasonal variations and distinct spatial disparities from upstream to downstream, and it was associated with certain ions such as Cl−. Anthropogenic Gd could be attributed to gadopentetic acid (Gd-DTPA), which is used in magnetic resonance imaging (MRI) in hospitals. This type of Gd was shown to be correlated with municipal wastewater. Due to the high stability and low particulate reactivity in water, anthropogenic Gd has great potential to serve as a tracer to prove the presence of medical wastewater.