Groundwater pollution, especially the co-contamination of emerging contaminants (ECs) and conventional contaminants, is increasingly recognized as a critical global concern. Karst aquifers are found throughout the world, providing critical water sources and sustaining rivers and ecosystems, and are particularly vulnerable to pollution. In this study, the characteristics of the contamination, potential sources, and source-specific health risks related to ECs and trace elements (TEs) in groundwater were investigated in Guiyang (a typical karst city in southwest China). The distribution of TEs followed a descending pattern from urban to suburban to rural areas. Interestingly, the median concentrations (217 ng/L) of Caffeine (CAF) in rural areas surpassed those in urban areas (145 ng/L) and even exceeded these in densely populated areas. Additionally, ECs and TEs in groundwater are significantly influenced by population density and land use types within a 1000-meter buffer zone around the sampling sites. Hierarchical cluster analysis and positive matrix factorization suggested that five principal sources of contamination were identified: domestic wastewater (29.7 %), industrial production (25.2 %), agricultural activities (16.3 %), natural and industrial sources (14.9 %), and pharmaceuticals (13.9 %). Monte Carlo simulations revealed that the non-carcinogenic risks to children in urban areas are significant, with 30.0 % of these risks exceeding the safety threshold. Source-specific health risk assessments indicated that industrial production is the primary source of risk. Furthermore, this study introduces a co-tracing method to trace the sources of groundwater contamination in karst systems. The co-tracing method based on the ECs and TEs allows for a deeper understanding of contaminant transfer and its fate in karst groundwater.