This study addresses the key scientific problem of urban safety in complex, hazard-inducing geological environments by focusing on representative towns in the Three Gorges Reservoir area. Through the integrated use of field investigations, numerical simulations, and multivariate statistical analysis, we developed a comprehensive model for assessing geological safety risk in reservoir-area towns. A four-tier deep safety evaluation system was constructed for two types of hazard-inducing geological environments, and a classification scheme for shallow susceptibility was proposed. On this basis, a five-tier integrated urban geological safety risk evaluation model was established that combines deep safety level, engineering sensitivity, shallow susceptibility, and prevention difficulty. The model exhibited strong performance (pseudo R² ≥ 0.914, p < 0.001) and indicates that risk is predominantly moderate (Grade III), with 85.7% of the 21 representative areas in Wushan, Fengjie, and other “2 + 4” towns falling into this category. Overall, the results provide an operational tool to support disaster risk reduction, risk-informed land-use governance, and resilient infrastructure planning, thereby contributing to sustainable urban development in reservoir-side mountainous regions.