Despite the growing awareness of heavy metal (HM) pollution, there remains limited understanding of HM distribution, sources, and risks within Egypt's Mediterranean Exclusive Economic Zone (EEZ), emphasizing the need for further research. This study aimed to address this gap by assessing HM contamination in coastal sediments across Egypt's EEZ using comprehensive pollution indices and risk assessment frameworks. Surface sediment samples were collected from nine sectors covering a 250-kilometer distance, with concentrations of Fe, Mn, Cu, Zn, Ni, Pb, Cd, and Cr analyzed using atomic absorption spectrophotometry. Fe showed the highest average concentration (17,783 ppm), while Cd exhibited the most alarming levels, with values reaching 5.19ppm in some areas. Contamination levels were evaluated through sediment quality guidelines (SQGs), including the Threshold Effect Level (TEL), Probable Effect Level (PEL), Effect Range Low (ERL), and Effect Range Medium (ERM), combined with pollution indices: the Geoaccumulation Index (Igeo), Contamination Factor (CF), Degree of Contamination (Cd), Modified Degree of Contamination (mCd), and Potential Ecological Risk Index (RI). Results revealed significant spatial variation in HM concentrations, with Fe and Mn dominating and Cd presenting the highest contamination and ecological risk. The Igeo classified Cd contamination as heavy to extremely heavy in several sectors, particularly near industrial and agricultural zones. Cd and Zn showed elevated CF values, emphasizing their anthropogenic origin, while Fe, Mn, and Cr were predominantly lithogenic. Ecological risk assessment indicated considerable to very high risks in hotspots off the Eastern Harbor, Damietta, and Manzala, predominantly driven by Cd. Statistical correlations highlighted common sources for Zn, Ni, Pb, and Cd, primarily linked to industrial discharges and agricultural runoff. These findings emphasize the urgent need for targeted mitigation measures to address Cd contamination and its ecological impacts. This study enhances understanding of HM distribution and sources in coastal sediments and provides critical insights for sustainable management of marine ecosystems in Egypt's EEZ.