Uterine fibroids are the most common benign smooth muscle neoplasm of the uterine wall and are a major indication for hysterectomy. Although common risk factors include African Ancestry, family history, obesity, and early menarche, exposure to non-essential metals is an emerging risk factor that has not been previously examined in Caribbean populations. In this cross-sectional study, a sample of the prospective Tobago Health Study, we assessed associations between individual urinary concentrations of metals and metal mixtures with self-reported uterine fibroid prevalence among 441 women (40–87 years old). We used logistic regression to estimate associations between concentrations of six metals (non-essential metals—arsenic, cadmium, and lead; essential metals—copper, manganese, and zinc) individually and as a mixture with the odds of uterine fibroids. Models were adjusted for urinary creatinine, age, body mass index, education, and number of live childbirths. We assessed the effects of metal mixtures using weighted quantile sum regression. The rate of prevalence of uterine fibroids was 48.3%. In adjusted models, each 10-fold increase in µg/L urinary concentrations of total arsenic, dimethylarsinic acid, and arsenobetaine was associated with 61%, 84%, and 38% higher odds of uterine fibroids, respectively (β: 1.61; 95% CI: 1.04, 2.53); (β: 1.84; 95% CI: 1.11, 3.09); and (β: 1.38; 95% CI: 1.05, 1.82). Other metals were not associated with the odds of uterine fibroids. We observed no significant associations between metal mixtures and the odds of uterine fibroids. Urinary arsenic and arsenical metabolites were associated with higher odds of uterine fibroids in a cohort of African Caribbean women. Raising awareness about arsenic and metal exposure is prudent, and further research in longitudinal studies is needed to replicate the findings of this study and inform policies for public health protection of women's health.