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The water quality of the northern Caspian Sea has not been well-known, and its contamination can adversely affect the health of swimmers and seashore residents. The study sought to determine the contamination state of the Caspian Sea in Kazakhstan and quantify human health risks coming from the existing heavy metals concentration. The Caspian Sea was found to be "fairly to marginally" contaminated (24 < CCME-WQI < 64), with Cd influencing the index significantly. Concentrations of Cd and Pb increase over time (seasonal Kendall test, p-values = 2–4 %) in sites near oil fields and ports, suggesting the significant role of anthropogenic sources in causing diverse pollution events. Pb demonstrated the highest variability and number of outliers (4.3 % of all samples with coefficients of variation reaching up to 175 %). The principal component analysis further revealed that various discharges from oilfields and upstream transport could contribute to the contamination by heavy metals and their concentrations. Contamination is associated with up to 6 % cancer risk for adults. The long exposure duration of swimmers in water increases risks by up to 18 %, indicating the local population is at a higher risk. In conclusion, statistical tests and analysis indicate the presence of anthropogenic sources, and risk assessment reveals swimming can contribute to cancer risk. [Display omitted] • Surface water quality was studied in the Kazakhstan's coastline of the Caspian Sea. • Human health risk assessment was conducted for swimming scenario. • Water quality can be categorized as fair to marginal according to index analysis. • Risks were acceptable without an extreme concentration or exposure duration. • Oil fields, upstream transport, and seaports were possible contamination sources. [ABSTRACT FROM AUTHOR]