This study presents a diagnostic of the current state of 114 stream sediment samples by their elemental concentrations (Sb, Cd, Pb, As, Cu, Zn, Ni, Cr, and Hg), collected from Ighardayane upstream on an area of 15 km2 located at the SE part of central Morocco where Tourtit and Ichoumellal, two abandoned mining sites of Stibnite, are located. Several approaches were used to model the analysis (i) enrichment factor (EF), (ii) sediment pollution index (IPS), (iii) probable effect concentration-quotients (PEC-Qs), and (iv) potential ecological risk index (PERI). Results show highly contaminated areas around the old mining sites by Sb As, Pb, and Cd. Cadmium and lead show 86.9 and 12.29% (respectively) of trace element pollution according to sediment pollution index. Twenty-eight percent of the sampled area is potentially highly toxic because of the presence of Hg, Pb, and Cd. The very similar distribution of pollution and toxicity of most analyzed trace elements may originate from the same source, which corresponds to mining wastes where we recorded the highest pollution and toxicity degrees. This environmental issue represents the combination of Tourtit and Ichoumellal anthropic sources responsible of Sb, As, Pb, and Cd release and a probable natural source of Hg “that needs a further study,” which contribute in the degradation of an aquatic ecosystem of the same area. Therefore, both ecotoxicological analysis and stream sediment quality management should be carried out to control this aquatic ecosystem toxication.