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Despite increasing mining activities, and fertilizer and pesticide use in agriculture, little information is available on the status of metal(loid) contamination in rivers in West Africa. Sixty water samples were collected from three significant rivers (the Bandama, Comoé, and Bia Rivers) in Côte d'Ivoire, the world's top cocoa producer, to examine As, Pb, Cu, Fe, Cd, and Zn concentrations, partitioning, and distribution in suspended particle-size fractions. The results showed higher total metal(loid) concentrations during the dry and flood seasons than during the rainy season. Significant As and Pb concentrations, moderate Cu and Fe concentrations, and low Zn concentrations were observed during the flood season. The metal(loid) concentrations decreased upstream to downstream primarily due to increased deposition through flocculation. Inverse or no obvious spatial trends often were observed, indicative of local contamination from anthropogenic activities. The suspended solid phase and the strength of metal affinity to the particles controlled the metal(loid) concentrations. Furthermore, total metal(loid) concentrations increased significantly with decreasing suspended particle-size fractions. The results underline that As and Pb contents in the Comoé and Bia Rivers threaten the health of at least 3 million people in southeastern Côte d'Ivoire. Filtering river waters before use will significantly reduce human health risks.