This research examines the contamination levels in the Pashur River in Bangladesh stemming from trace metal discharge originating from the Mongla seaport and various industrial outlets. It delves into both ecological risks and potential health hazards for humans consuming fish carrying accumulated trace metals. The research employed atomic absorption spectrometry to measure the concentrations of chromium (Cr), arsenic (As), manganese (Mn), copper (Cu), zinc (Zn), nickel (Ni), lead (Pb), and cadmium (Cd) in surface water, sediment, and fish samples. Target hazard quotient (THQ) and carcinogenic risks were calculated to determine the human health risk caused by the consumption of these targeted fish species. An RI value of 42.89 indicates that the collective presence of trace metals in sediment poses significant ecological risks to the study area. Although the majority of trace metals present in sediment are categorized under class 1 (ranging from unpolluted to moderately polluted) based on the Igeo values, Cd is classified under class 2, signifying a moderate level of pollution. Significantly, THQ values surpass the threshold of 1 for Cr and As, indicating potential health risks associated with the consumption of specific fish species. Among the trace metals analyzed, Ni demonstrates the highest cancer risk (CR) value, at 5.78 × 103, indicating a notable cancer risk associated with the consumption of targeted fish. Recommendations include the strict enforcement of waste disposal policies to mitigate anthropogenic discharge and safeguard the river from further pollution.