Abstract Economic growth and increased human activities have led to the discharge of significant amounts of metal pollutants into aquatic environments. Polymesoda erosa, a filter-feeding clam species, serve as a valuable bioindicator for assessing the presence of metal elements. As a prominent clam species and a significant protein source in Southeast Asia, its safety for consumption warrants evaluation. This study aims to examine the distributions of metal elements in P. erosa collected from Kemaman River, Terengganu, and assess the safety of its consumption using Target Hazard Quotients (THQ). The concentrations of Cd, Cu, Cr, Pb, and Zn in samples were determined using the acid digestion method. The findings revealed that metal variability in P. erosa resulted from anthropogenic factors. The metal concentrations in P. erosa followed the order of Zn > Cu > Pb > Cd > Cr. Variations in metal accumulation were likely influenced by differing environmental conditions and the proximity to study areas. Preliminary risk assessment indicated that the levels of Pb, Cd, and Zn in P. erosa exceeded the tolerable limits for safe consumption. Therefore, it is recommended that the consumption of P. erosa be moderated to minimize potential health risks.