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Despite global warming, extreme low-temperature stress (LTS) events pose a significant threat to rice production (especially in East Asia) that can significantly impact micronutrient and heavy metal elements in rice. With two billion people worldwide facing micronutrient deficiencies (MNDs) and widespread heavy metal pollution in rice, understanding these impacts is crucial. We conducted detailed extreme LTS experiments with two rice (Oryza sativa L.) cultivars (Huaidao 5 and Nanjing 46) grown under four temperature levels (from 21/27 °C to 6/12 °C) and three LTS durations (three, six, and nine days). We observed significant interaction effects for LTS at different growth stages, durations and temperature levels on the contents and accumulation of mineral elements. The contents of most mineral elements (such Fe, Zn, As, Cu, and Cd) increased significantly under severe LTS at flowering, but decreased under LTS at the grain-filling stage. The accumulations of all mineral elements decreased at the three growth stages under LTS due to decreased grain weight. The contents and accumulation of mineral elements were more sensitive to LTS at the peak flowering stage than at the other two stages. Furthermore, the contents of most mineral elements in Nanjing 46 show larger variation under LTS compared to Huaidao 5. Accumulated cold degree days (ACDD, °C·d) were found to be suitable for quantifying the effects of LTS on the relative contents and accumulations of mineral elements. LTS at the flowering stage will help alleviate MNDs, but may also increase potential health risks from heavy metals. These results provide valuable insights for evaluating future climate change impacts on rice grain quality and potential health risks from heavy metals. [Display omitted] • LTS effects on mineral elements depend on growth stages, LTS durations and levels. • LTS at flowering will alleviate the MNDs, but also increased heavy metals content. • ACDD quantified the LTS effect on content and accumulation of mineral elements well. • LTS effects on mineral elements at early flowering stage was more sensitive than other treatment stages. [ABSTRACT FROM AUTHOR]