Sediment quality and trace metal accumulation are two of the most pressing issues facing the aquatic ecosystem around the world. Twenty-four (24) samples of stream sediments were collected along the Dibamba River, in the economic and industrial capital of Cameroon, to judge the trace metal levels in this river flowing near the city of Douala. Trace metal concentrations were disclosed with an ICP-MS on two different grain size fractions (very fine-grained sand and clay). The sediments indicate possible adverse effects of trace metals on surrounding biota as elements like Cr, Cu, Ni, Zn, Pb, and Hg show positive enrichment of greater than 1 when compared to background values from the upper continental crust (UCC) and sediment quality factors such as TEL (threshold effects level), PEL (probable effects level), ERL (effects range low), and ERM (effects range medium) values. The sediments show values of Degree of contamination (DC = 2–4), Pollution load index (PI = 1–2), and individual potential risk (EI = 92–219) indicating moderate pollution and ecological risk. Statistical and multivariate analyses point to both anthropogenic and geogenic sources for the heavy metals in the Dibamba stream sediments. The geogenic origin of the heavy metals is linked to the weathering of gneiss and migmatite found in the river banks. This study found low to mild levels of metal pollution and toxicity in the sediment, but it also warned that the continued development of nearby industries and businesses, the provision of transportation services, and waste disposal activities could result in a gradual outflow and accumulation of metals in the sediment, endangering the aquatic ecosystem.