Managing municipal solid waste (MSW) in urban areas of developing countries is a significant challenge due to rapid urbanization and inadequate infrastructure. This study aims to quantify the MSW at Aler dumpsite in Lira City, Uganda, and assess the associated environmental and health risks. Our findings revealed a daily dumping rate of 7.38 tons, predominantly organic waste. Leachate from the site exceeded WHO limits for nutrients and heavy metals, with exceptionally high amounts of cadmium (Cd) found in soil (4.8 mg/kg) and vegetables. The water quality in nearby streams was poor, rendering it unfit for consumption due to elevated ion and nutrient levels. Health risk assessments indicated significant non-carcinogenic risks from heavy metal ingestion, with a hazard index (HI) of 4.6 for adults and 9.6 for children. While dermal exposure risks were generally low, children were at risk from stream 1 (HQderm = 1.165). Vegetable analysis revealed levels of lead (Pb), cadmium (Cd), zinc (Zn), and nickel (Ni) above safe doses, posing significant non-carcinogenic risks. To address these issues, we recommend increasing public awareness to avoid consuming water and vegetables from areas around the dump site. Additionally, we suggest that the responsible authorities improve MSW management by constructing sanitary landfills to minimize water, soil, and plant pollution from landfill leachate.