This study focuses on the diffusion patterns of principal ore-forming elements (Pb and Zn) and associated elements (Cd, Cu, Cr, and As) in lead-zinc ore. Sampling points in upwind and downwind directions of lead-zinc ore areas at various densities (1 N/km2 – 4 N/km2) were categorized. This study analyzed the statistical relationship between the content of PTEs in the soil around lead-zinc ore and the source strength and dominant wind direction, constructed one-dimensional and two-dimensional diffusion model, and simulated the EER scope caused by PTEs. The findings indicate that: (1) concerning source strength, the content of PTEs in soils of high-density ore aggregation areas is significantly higher than in low-density ore aggregation areas. However, the impact of source strength decreases with decreasing ore grade, with a difference in Pb content of 1.71 times among principal ore-forming elements and almost consistent Cd content among associated elements. (2) Regarding the transport pathways, for most PTEs, the inverse proportion coefficients downwind are higher than upwind, approximately 1.18–3.63 times, indicating greater migration distances of PTEs downwind due to atmospheric dispersion. (3) By establishing a two-dimensional risk diffusion model, the study simulates the maximum radius of risk diffusion (r = 5.7 km), the 50% probability radius (r = 3.1 km), and the minimum radius (r = 0.8 km) based on the maximum, median, and minimum values statistically obtained from the EER. This study provides a scientific basis for implementing preventive measures for PTEs accumulation in soil within different pollution ranges. Different risk prevention and control measures should be adopted for PTEs accumulation in soil within the three ranges after cutting off pollution sources. Subsequent research should further investigate the impact and contribution of atmospheric transmission and surface runoff on the diffusion of PTEs in areas with high risk near lead-zinc ore.