To analyze the dietary intake risk of pesticide residues in fruits, the impact of bioaccessibility on the dietary intake risk of pesticide residues in fruits was explored. Liquid chromatography-triple quadrupole tandem mass spectrometry (LC-MS-MS) was used to detect and analyze the 8 pesticide residues in 4 kinds of commercially available fruits, and in vitro gastrointestinal simulation was performed to determine the bioaccessibility of pesticides in fruits. Chronic and acute dietary intake assessment methods, along with pesticide bioaccessibility evaluation, were conducted to assess the dietary exposure risk of pesticide residues in fruits. The concentrations of detected pesticides in fruits ranged from 0.01 mg/kg to 0.84 mg/kg. The bioaccessibility of pesticides was 21.50% (Wogan, pyridaben) or 94.37% (pear, dimethomorph), with the bioaccessible concentrations in the simulated gastrointestinal fluid being 0.016~3.48 mg/kg. Among the children aged 4~6 years and the general population, the chronic dietary exposure risk %ADI values were 0.05%~3.36% and 0.01%~0.92%, respectively, and acute dietary exposure risk %ARfD values were 0.23%~16.60% and 0.08%~5.88%, respectively, all were within the acceptable range. After bioavailability was ignored, the dietary exposure risk assessment results would be overestimated by 5.63%~78.50%. The bioaccessibility of pesticides in fruits varies with the type of fruit and difference of pesticide. The dietary risk is the comprehensive assessment result of pesticide exposure, toxicity, and fruit consumption. Combined with bioaccessibility, the accessible concentrations and exposure risk of pesticides in fruits are reduced. Therefore, the use of bioavailability in risk assessment can provide a theoretical basis for accurately evaluating the health risks of ingested pollutants to humans.