The accumulation of potential toxic elements in agricultural soil and rice is of particular concern in China. However, studies on the risk assessment of these elements in regional soil–rice systems remain limited. The aim of this study is to evaluate the pollution status and potential health risk of potential toxic elements in typical paddy soil and rice in Henan Province. A total of 80 soil samples and corresponding rice samples were collected to determine the contents of Cd, Pb, As, Cr, Cu, Zn, and Ni, and to assess their potential health risks to local consumers. Results showed that the average contents of these elements in soils were below the national risk screening values in GB15618-2018. Only the average content of Cr in rice exceeded the limit in GB 2762-2022 specified by the national food safety standard. The rates of exceeding the limits for Cd, Pb, As, and Cr in rice samples were 13.89%, 15.28%, 15.28%, and 27.78%, respectively. The health risk assessment indicated that rice intake for both adults and children caused carcinogenic and non-carcinogenic health risks to varying degrees. Local residents are advised to purchase rice from outside the study area to meet their daily needs and strictly regulate the pollution of potential toxic elements within the area.