This study examines the presence of toxic metals (arsenic, mercury, cadmium, and lead) in aquatic environments, fish, and seafood products in Central Asia, and conducts a risk assessment. Despite limited studies, the research highlights that while overall fish and seafood consumption in Central Asia remains below recommended levels, regions with high fish consumption may face elevated exposure to toxic metals, particularly mercury. The study emphasizes the need for comprehensive monitoring, regulation, and remediation efforts to ensure water and food safety. Public awareness campaigns and dietary guidelines are crucial to minimize health risks associated with toxic metal exposure. The review also discusses the distribution of toxic metals in Central Asian waters, the occurrence of these metals in fish and seafood, and human biomonitoring studies, providing insights into the health impacts and future directions for addressing toxic metal contamination in the region.This study examines the presence of toxic metals (arsenic, mercury, cadmium, and lead) in aquatic environments, fish, and seafood products in Central Asia, and conducts a risk assessment. Despite limited studies, the research highlights that while overall fish and seafood consumption in Central Asia remains below recommended levels, regions with high fish consumption may face elevated exposure to toxic metals, particularly mercury. The study emphasizes the need for comprehensive monitoring, regulation, and remediation efforts to ensure water and food safety. Public awareness campaigns and dietary guidelines are crucial to minimize health risks associated with toxic metal exposure. The review also discusses the distribution of toxic metals in Central Asian waters, the occurrence of these metals in fish and seafood, and human biomonitoring studies, providing insights into the health impacts and future directions for addressing toxic metal contamination in the region.