The sources, distribution, levels and sinks of perfluorooctane sulfonate (PFOS) estimated to be released from areas of high population density, have been explored using the river Rhine as a case study. A comparison between modelled and measured data is presented, along with analysis of the importance of PFOS sorption in riverine systems. PFOS releases into the Rhine were estimated to be 325-690 kg/yr based on per capita emission rates of 27-57 μg day ^-1 from a population of 33 million living within a 50 km zone either side of the river. Sorption of PFOS to suspended particles and sediments may alter its fate in the aquatic environment. Therefore available measured and modelled partitioning data was assessed, and K _d values (sorption coefficient) of 7.5 and 20 were selected. This resulted in sediment-water ratios of 23-76:1, which are similar to ratios reported in the literature, and resulted in modelled estimates that <20% of the total PFOS entering the Rhine binds to sediments or suspended particles. The calculated discharge from the Rhine to the North Sea based on measured data was 420-2200 kg/yr; our model predictions are in good agreement with these estimates. Emission trends were accurately predicted, suggesting population density can be effectively used as a surrogate for diffuse PFOS emissions from product use, while predicted concentrations were a factor of 2-4 below measured data showing the importance of other sources. Transfer of PFOS to sediment is estimated to be minimal, and consequently discharges to the North Sea are roughly equal to PFOS releases to river water.