ABSTRACT Pollution in the Noyyal river is a well-known and documented issue and recently, heavy metal contamination has become a serious issue requiring immediate attention. So, to understand the severity of heavy metal contamination in the surface water and sediments of the Noyyal river, a comprehensive study was conducted. About 27 surface water samples and 25 sediment samples were collected at different sites along the Noyyal river. The concentrations of heavy metals were determined using inductively coupled plasma mass spectrometry (ICP-MS). The Noyyal river’s surface water showed significant variations with nickel (Ni), copper (Cu), and zinc (Zn) concentrations exceeding acceptable limits for irrigation and aquatic life. Lead (Pb) concentrations were within acceptable limits for irrigation but potentially harmful to aquatic organisms. Noyyal river sediments also contained varying concentrations of chromium (Cr), copper (Cu), nickel (Ni), zinc (Zn), and gallium (Ga). Various assessment indices were employed to assess the eco-biological and human health risks associated with heavy metal contamination. The results highlighted alarming ecological and biological risks due to the accumulation of trace metals. Sediments exhibited high ecological risk (ERI values ranging from 43.81 to 371.43), while surface water samples intended for irrigation and aquatic purposes displayed extreme risks (ERI values exceeding 1200) to agricultural crops and aquatic organisms. The probability of toxicity to aquatic organisms, particularly benthic communities, was over 76% according to the biological risk assessment. The study also identified potential non-carcinogenic risks associated with metals like chromium (Cr), copper (Cu), nickel (Ni), and zinc (Zn) in the sediments. Moreover, elevated levels of Cr, Ni, and Cu in both sediments and surface water were likely to pose significant carcinogenic risks to exposed adults. Additionally, the heavy metal toxicity load in both surface water and sediments exceeded permissible limits, highlighting the urgent need for efficient removal strategies.