Heavy metal pollution in the Danube Delta (in sediments, water and living organisms) has recently received increasing attention due to its impact on ecosystems health and water quality. However, long term records of heavy metal contamination are not available to date. In this study radiometric dating and geochemical analyses for major elements (Al, Fe, Ca and S) and metals (Cu, Zn, Pb, Ni, Cr and Cd) were performed on the top 4 m of a 9-m sediment core retrieved from the alluvial plain of Sulina distributary channel aiming to reconstruct the heavy metal geological background and contamination history and discuss the possible origins (natural vs. anthropogenic) of metals and the main factors driving their temporal variation. Chronological analysis revealed that the top 4 m of the core span the last ~600 years. Three distinct sediment units (U1: 400–200, U2: 200–140, U3: 140–15) were identified based on the downcore element concentration variation. The lower unit (400–200 cm, ~1450–1700 CE) shows an upward increase of Cu, Zn, Pb, Ni, Cr and Cd metal contents, which are strongly correlated with Al. Enrichment factor (EF) analysis indicates that metals detected in this unit are derived primarily from natural sources. In contrast, metals show elevated EF values within the middle (200–140 cm, ~1700–1770 CE) and upper unit (140–15 cm, ~1770 CE to present). The highest degrees of enrichment of Cu, Zn and Cd occur in the peat layer of the middle unit (U2) which displays higher organic carbon and sulfur contents, indicating that diagenetic enrichment of detected metals occurs under reducing condition. Overall, sediment contamination is moderate while the level increases with time. This study provides new insights into the metal contamination history of deltaic environments and yields baseline values for heavy metal contents in pristine sediments deposited prior to the onset of anthropogenic impact.