With rapid urbanization, intensified agricultural activities, and industrialization, groundwater resources are increasingly threatened by pollution. Industrial wastewater discharge and the extensive use of agricultural fertilizers in particular, have had substantial impacts on groundwater quality. This study examines 18 groundwater samples collected from the main urban area of Yibin City to assess hydrochemical characteristics, spatial distribution, source attribution, water quality, and human health risks. Statistical analysis reveals significant exceedances in TDS, NO₃⁻, Mn, and As levels in groundwater, with elevated concentrations of B as well. Isotopic analysis identifies atmospheric rainfall as the primary recharge source for groundwater in the area, with water–rock interactions and limestone dissolution playing key roles in shaping its chemical composition. Applying the Entropy-Weighted Water Quality Index (EWQI) for a comprehensive water quality assessment, the study found that 94.44% of groundwater samples were rated as “good”, indicating relatively high overall water quality. Deterministic health risk assessments indicate that 72.22% of the groundwater samples have non-carcinogenic health risks below the threshold of 1, while 66.67% have carcinogenic health risks below 1.00 × 10⁻⁴. Monte Carlo simulations produced similar results, reinforcing the reliability of the health risk assessment. Although the study area’s groundwater quality is generally good, a significant human health risk persists, underscoring the need to ensure the safety of drinking and household water for local residents. This study provides a valuable reference for the rational management and remediation of groundwater resources.