The prime goal of this study was to assess the surface water quality and the associated health risks for residents in the Tano South Municipality, Ghana. The WHO drinking water criteria were compared with the findings of an analysis of eight surface waters for parameters such as physiochemical parameters, nutrient levels, and concentrations of selected metals. An evaluation was performed regarding the potential non-carcinogenic and carcinogenic risks associated with metal exposure by oral and dermal absorption. The estimated water quality index indicated that seven water samples were deemed unsuitable for human consumption, while one sample indicated very low water quality. The fluoride levels in all water samples were below the limit of detection, although it guards against dental caries. All of the water samples had mean concentrations of Cd and Fe above WHO guideline values, while one water sample had a Pb concentration that was higher than recommended. Principal component analysis showed that aside from the natural source, human-induced sources such as runoff of excess chemicals and soil erosion from adjacent farm soils were responsible for the substantial levels of contaminants in surface water samples. There was a possibility of non-carcinogenic consequences for children in seven out of eight water samples. However, cancer risk for Cd and Pb was not likely for adults and children in the study area. Findings serve as a representative case study for other districts and call on water managers to treat surface waters to guard against harmful health consequences and safeguard the designated buffer zones.