The effects of human activities on heavy metal distributions and fractionation in sediments from villages around Baiyangdian Lake (BYDL), North China, were assessed. The concentrations of Cd, Cr, Cu, Ni, Pb, and Zn in sediments from five villages were determined, and the potential ecological risk index, risk assessment code, and Chironomus sp. larvae toxicity assay were used to assess the bioavailabilities and toxicities of the metals. The contribution of Cd to the potential ecological risk was 45.13-89.53%, the highest among the heavy metals investigated. The contributions of Cd, Pb, and Zn in the non-residual fractions to the total concentrations were 66.23-90.57%, 18.31-96.28%, and 8.89-76.84%, respectively, which indicated that these metals had important anthropogenic sources and were very bioavailable. The mean risk assessment codes decreased in the order of Cd (49.82%) > Zn (20.95%) > Cu (9.35%) > Pb (6.88%) > Ni (4.85%) > Cr (0.30%), and the toxicity of Cd and Zn to biota around BYDL is of concern. The mean survival rate of Chironomus sp. larvae in sediments from Dizhuang village was 44.02%, which indicated that there was a high degree of heavy metal toxicity, particularly in waterways around the village. Carboxylesterase and superoxide dismutase analysis results indicated that heavy metals could markedly increase or decrease enzyme activities in Chironomus sp. larvae. Overall, the results indicated that heavy metal pollution in villages around BYDL should be taken into consideration for its ecological management.