Heavy metals in road dusts can directly pose significant health risks through ingestion, inhalation, and dermal contact. This study investigated the pollution, distribution, and health effect of heavy metals in street dust from industrial, capital city, and peri-urban areas of Bangladesh. Inductively coupled plasma mass spectrometry (ICP-MS) examined eight hazardous heavy metals such as Zn, Cu, Pb, Ni, Mn, Cr, Cd, and Co. Results revealed that industrial areas showed the highest metal concentrations, following the order Mn > Zn > Cr > Pb > Ni > Co > Cd, with an average level of 444.35, 299.25, 238.31, 54.22, 52.78, 45.66, and 2.73 mg/kg, respectively, for fine particles (≤20 μm). Conversely, multivariate statistical analyses were conducted to assess pollution levels and sources. Anthropogenic activities like traffic emissions, construction, and industrial processing were the main pollution sources. A pollution load index revealed that industrial areas had significantly higher pollution (PLI of 2.45), while the capital city and peri-urban areas experienced moderate pollution (PLI of 1.54 and 1.59). Hazard index values were below the safety level of 1, but health risk evaluations revealed increased non-carcinogenic risks for children, especially from Cr, Ni, Cd, and Pb where Cr poses the highest cancer risk via inhalation, with values reaching 1.13 × 10−4–5.96 × 10−4 falling within the threshold level (10−4 to 10−6). These results underline the need for continuous environmental monitoring and pollution control in order to lower health hazards.