The sources, distribution, transformation, toxicity and accumulation of persistent organic pollutants (POPs) in aquatic and terrestrial ecosystems have attracted global concern and attention over the last several decades. Although, POPs are toxic, degrade slowly and have a tendency to accumulate in the food chain, they are still widely used worldwide in many fields, such as industrial and agricultural activities. In addition, discharge of POPs into waterways may lead to serious health-related and environmental problems. This review provides an overview of the continental distributions of many types of POPs and the health risks associated with the exposure to POPs in daily life. This review also discusses the distribution of POPs in Malaysia, and the future work that will be conducted in the Klang River, one of the basins subjected to pollution due to development and urbanization.