This study examines the accumulation, distribution, and mobility of Potentially Toxic Elements (PTEs) in the sediments of a low‐lying coastal drainage network (Ravenna, Italy). The aim is to understand the geochemical processes occurring between drainage water and canal bed sediments and assess factors affecting and driving PTE distribution and enrichment in these environments. A geochemical database resulting from the analysis of 203 drainage sediment samples was analyzed using Principal Component Analysis and compared to undisturbed near‐surface sediment samples from the same depth and depositional environment. The results reveal PTEs exceeding national regulation limits. Distance from the sea, electrical conductivity of drainage water, and fertilizer use were identified as the main driving factors. The primary mechanisms for PTE precipitation (As, Co, Mo) and subsequent enrichment in the sediments is attributed to the absorption on Fe‐ and Mn‐oxyhydroxides (HFO and HMO), particularly in high salinity areas near the coast. While Cu, Zn, Pb, Cr, and V also have affinity for HFO and HMO, their adsorption efficiency decreases due to the competition with salt‐derived cations during ongoing salinization processes. Anthropogenic sources, including agriculture, hunting activities, traffic dust, and railways, contribute to the local abundance of other elements (Cr, Ni, Cu, Zn, Pb, and Sn). This paper's significant progress lies in assessing the concurrent interactions of chemical and physical processes that drive PTE distribution and accumulation in reclaimed low‐lying coastal plains. The findings are significant for assessing PTE accumulation risks and sediment toxicity in coastal areas affected by water salinization, drainage, and subsidence, providing valuable information to water management institutions globally. Plain Language Summary: This study investigates the presence of harmful substances called Potentially Toxic Elements (PTEs) in the sediment of the drainage canals in Ravenna's coastal area (Northern Italy). Researchers want to understand how these substances accumulate and spread in the sediment and what factors influence their distribution. They collected sediment samples from the bottom of the drainage canals and compared them to natural sediment samples. The results show that the PTE levels exceed the national and international limits. The distance from the sea, the water salinity, and the fertilizers are found to be the main factors affecting the distribution of PTEs. The researchers also discover that some PTEs (Arsenic, Cobalt, and Molybdenum) are absorbed by certain minerals in the sediment, especially in areas with high salinity close to the coast. However, other harmful elements, like copper, zinc, lead, chromium, and vanadium are not as strongly absorbed due to competition with salt‐related substances. The abundance of other elements like chromium, nickel, copper, zinc, lead, and tin come from human activities like agriculture, hunting, traffic, and railways. These findings are important for understanding the risks associated with these substances in the sediment, particularly in low‐lying coastal areas that have been reclaimed for human use. Key Points: First study on Potentially Toxic Elements (PTEs) enrichment in drainage canal sediments of reclaimed low‐lying coastal areaKey roles of (i) Fe‐ and Mn‐oxyhydroxides in PTE enrichments and (ii) salt‐derived cations in adsorption efficiencyDistance from the sea, salinity of drainage water, and use of fertilizers are the main factors affecting the distribution and enrichment of PTEs [ABSTRACT FROM AUTHOR]