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Fish constitutes the main protein source for the Amazonian population. However, the impact of different anthropogenic activities on trace element and metal accumulation in fish and their risks for human health at a regional scale remain largely unexplored. Here we assessed exposure levels of 10 trace elements and metals (Cr, Mn, Fe, Ni, Cu, Zn, As, Cd, Pb, and Hg) in 56 samples belonging to 11 different species of fish from the Brazilian Amazon. We studied the relationship between exposure levels, fish origin, and fish feeding habits, and assessed toxicological and carcinogenic risks for the Amazonian population. No significant correlation was found between sampling site and exposure levels to the studied elements, but a significant difference was found between the accumulation of some metals and the position of the fish species in the food chain. The concentrations of Cr and Hg in fish flesh were found to exceed the Brazilian limits for human consumption. This study shows that current fish consumption patterns can lead to estimated daily intakes of Hg, As and Cr that exceed the oral reference dose, thus posing a toxicological concern. Furthermore, carcinogenic risks may be expected due to the continued exposure to Cr and As. The results of this study show that the consumption of wild caught fish in the Amazon region should be controlled. Moreover, continued monitoring of trace element and metal contamination in fish and on the health of the Amazonian population is recommended, particularly for riverine and indigenous communities., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)