An industrial accident resulted in a gas oil spill of 11,808 barrels in the upper part of the Coatzacoalcos River watershed. After river shore cleanup, concentrations of total petroleum hydrocarbons (TPH) and polycyclic aromatic hydrocarbons (PAH) in muscle (+ skin) were determined in captured fish to evaluate human health risk due to fish consumption post-spill in the most affected communities. Data on fish consumption, body weight, and diet factor were collected by questionnaires and field observations. Using standard formulas for carcinogenic and non-carcinogenic substances, site-specific remediation levels were calculated in fish, comparing them to the real levels observed. Likewise, the levels of PAHs in fish captured pre- and post-spill were compared to determine their origin (pyrolytic vs. petrogenic). The TPH concentrations were between 119,000 and 523,000 ng/g (dry weight) and no significant difference (P > 0.05) was found pre- vs. post-spill. The concentration of total PAHs varied between 2494.83 and 35,412.23 ng/g (dry weight), with the concentrations of naphthalene (520.9 ng/g) and phenanthrene (7532.7 ng/g) being much higher than in control samples, and being from the gas oil spill (petrogenic origin). The site-specific remediation levels calculated for TPH and PAH were much higher than the maximum levels actually detected. No human health risks were found from hydrocarbons from the spill, at least after cleanup efforts and natural attenuation (six months).