This research quantifies the health risks associated with exposure to heavy metals in the Matjhabeng Local Municipality, a gold mining region in South Africa, utilising a deterministic source–pathway–receptor approach. This study uniquely integrates both non-carcinogenic and carcinogenic risk assessments across multiple heavy metals, providing a comprehensive perspective on health impacts in mining-impacted communities. The study measured concentrations of arsenic (As), cadmium (Cd), lead (Pb), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), nickel (Ni), selenium (Se), and zinc (Zn) in soil samples, with mean values found to be 3.2 mg/kg, 2.5 mg/kg, 45 mg/kg, 17 mg/kg, and 25 mg/kg for As, Cd, Pb, Co, and Cr, respectively. The deterministic assessment revealed minimal non-carcinogenic risks for ingestion across all demographics (HQ < 1), while significant dermal risks were identified for Cd, Pb, Co, and Cr (HQ > 1), particularly for the adult group. The inhalation pathway emerged as a critical exposure route, with HQ values ranging from 5 to 15 and chronic hazard index values significantly exceeding safe limits (CHI > 5). The carcinogenic risk through inhalation notably surpassed the acceptable thresholds set by the United States Environmental Protection Agency (1 × 10−4 to 1 × 10−6), with a calculated lifetime cancer risk far exceeding the limit for As, Cd, Cr, Co, and Ni for both adults and juveniles. These findings underscore the urgent need for targeted risk mitigation strategies in the community to address the significant health risks posed by airborne heavy metal exposure.