In order to assess the bioaccumulation and health risk of metals in a river reservoir, concentrations of copper (Cu), zinc (Zn), lead (Pb), cadmium (Cd), arsenic (As), and mercury (Hg) in the water, sediments, two small-sized fish, and a freshwater mussel from the Zhoubai reservoir were examined. The results indicated that all of these metals conform with class one of environmental quality standards for surface water (State Environmental Protection Administration of China, GB 3838-2002). There were no significant differences for total metal concentrations in sediment between the three sampling sites (p > 0.05), but the bioavailable concentrations in S3 were the lowest. The Cd was dominated with exchangeable fraction and showed considerable risk. All metal concentrations except for Pb in Rhodeus sinensis were significantly higher than those in Ctenogobius giurinus (p < 0.05). The metal concentrations in Cristaria plicata showed a similar pattern of bioavailable metals in sediment, indicating that the metal concentrations in aquatic organisms were determined by the bioavailable forms of metals. Negative correlations were observed between the size of fish and concentrations of Cu, Zn, Pb, Cd, and As. However, significant positive correlations were found between the size of mussel and concentrations of Cd (p < 0.01), As (p < 0.05), and Hg (p < 0.01). Zn had the highest BCF values in fish and mussel. The aquatic organisms showed lower ability of metal bioaccumulation from the sediment. Low values of target hazard quotient (THQ), hazard index (HI), and carcinogenic risk (CR) indicated that these metals do not pose a health risk to public through fish and mussel consumption in this study area.