China has been the largest producer and emitter of perfluorooctanoic acid and its salts (PFOA/PFO). However, the flows of PFOA/PFO from manufacture and application to the environment are indistinct, especially flows from waste treatment sites to the environment. Here, a life cycle analysis of PFOA/PFO is conducted in which all major flows of PFOA/PFO have been characterized for 2012. Processes related to uses and possible releases of PFOA/PFO include manufacture and use, waste management, and environmental storage. During manufacture and use, emission from application was the most important (117.0 t), regardless of whether it flowed first to waste treatment facilities or was directly released to the environment, followed by manufacture of PFOA/PFO (3.9 t), while flows from the service life and end of life of consumer products were the lowest (1.2 t). Among five waste treatment routes, flows through wastewater treatment plants (WWTPs) were the highest (10.6 t), which resulted in 12.8 t of PFOA/PFO being emitted into the environment. Masses of PFOA/PFO emission were estimated to be 96.3 t to the hydrosphere, 25.6 t to the atmosphere, and 3.2 t to soils. Therefore, control over reduction of PFOA/PFO should focus on application of reliable alternatives and emission reduction from WWTPs using effective treatment techniques.