The increasing population, rapid industrial expansion, and intensive use of agrochemicals have significantly contributed to the deterioration of the water ecosystem. In particular, contamination by toxic metals has emerged as a critical environmental and public health concern. This review focuses on examining the extent, contributing sources, and environmental and health impacts of toxic metal pollution in Ethiopia. Most importantly, this review focuses on key pollutants originating from industrial, agricultural, and domestic discharges. Specifically, it evaluates water quality trends, health risks associated with exposure to toxic metals, and existing mitigation strategies. These findings reveal that toxic metal concentrations in various aquatic systems, particularly near industrial zones, frequently exceed permissible limits. Groundwater health risk assessments using hazard quotient and incremental lifetime cancer risk models indicate a serious threat to communities dependent on these sources for drinking water. Additionally, the review identifies a lack of comprehensive water monitoring frameworks and insufficient wastewater treatment infrastructure across the country. To address these challenges, this study examines both conventional and emerging remediation technologies, highlighting recent modeling approaches for identifying pollution sources. This review consolidates fragmented research on the topic and provides strategic direction for future studies and policy formulation. Ultimately, it contributes to the ongoing discourse on sustainable water management and opens new pathways for implementing localized water treatment solutions to mitigate toxic metal contamination in the aquatic ecosystem. • Assessing toxic metal contamination in Ethiopia’s water sources. • Evaluating health risks using hazard quotient and cancer risk models. • Identifying industrial and agricultural sources of toxic metal pollution. • Highlighting gaps in water quality regulations and policy enforcement. • Proposing sustainable mitigation strategies for water contamination.
Ambaye et al. (2026) studied this question.