The current research was conducted to assess potential health risks for human consumers and the effects of various anthropogenic actions on the heavy metal load in O. niloticus gathered at various sites in the Damietta branch (Egypt). In fish muscles, metals accumulated in the following sequence: Fe > Zn > Cu > Mn > Pb. Among all sample locations, station 6 recorded the greatest values for metal pollution index (MPI) and hazard quotient, aligned with a higher metal pollution index. The current study may serve as a warning to regular consumers, especially given the high consumption rates of the Oreochromis type. In Oreochromis niloticus, metal buildup exhibited tissue-specific patterns. The liver and gill tissues were high bio accumulators compared to muscle tissues, as evidenced by the computed bioaccumulation factor and metal pollution index. The hazard index (H.I.) calculation showed that individual metals had a modest H.I. However, the combined effects of total metals posed a severe risk to eaters.