The Olifants River, a major tributary of the Limpopo River, is one of the most polluted rivers in South Africa. Consequently, concerns regarding the human health impact of long-term consumption of fish from the Olifants River have been raised in recent studies. Nevertheless, Lake Flag Boshielo situated on the main stem of the Olifants River has been proposed as a site for an inland fishery. Planktivorous silver carp Hypophthalmichthys molitrix (Valenciennes, 1844) is among the potential target species for such a fishery. Therefore, a desk-top human health risk assessment was conducted for silver carp from Lake Flag Boshielo. From January to November 2013, muscle samples from 50 specimens were collected and analysed for metals and metalloids. The hazard quotient based on a weekly meal of 150 g exceeded the acceptable level for As, Cd, Cr, Co, Pb, Hg, Se, V and Zn. Compared with previous studies from Lake Flag Boshielo, muscle tissue concentrations of As, Cr, Pb, Hg, Se, V and Zn for H. molitrix were higher. Based on the metal and metalloid concentrations reported in this study, long-term consumption of silver carp from Lake Flag Boshielo might pose a health risk to impoverished rural communities.