Abstract: This study is part of a larger on-going environmental monitoring and assessment of water, sediment and biota in the Tarkwa Nsuaem Gold mining area. Assessment of risks is central to risk mitigation and reduction of human health impacts. The study set out to assess health risks via the Central Tendency Exposure (CTE) and Reasonable Maximum Exposure (RME) scenarios to resident adults and children from exposure to arsenic, manganese and lead in surface and groundwater. The results indicate that hazard quotients for these pollutants are mostly within range of the United States Environment Protection Agency (USEPA) acceptable risk. The RME of Mn through oral contact for Children (hazard quotient of 18) is considerably higher than the USEPA acceptable risk value of 1.0. While at some locations, the RME of Mn through oral contact for adults also exceeded the standard, a comparison of contributions of oral and dermal contact to the health risk, shows that the former accounts for more. Carcinogenic risks to resident adults arising from exposure to arsenic show RME values ranging from 5.0x10-4 to 1.1x10-3. These values were up to 11 times greater than the USEPA acceptable range for excess risk of cancer. Arsenic- related cancer risks to resident adults for CTE ranged from 3.7x10-4 to 6.7x10-4; also higher than the USEPA acceptable range for excess risk of cancer. Likewise, the cancer risks to resident children for both CTE and RME scenarios were greater than the USEPA acceptable range for excess risk of cancer. These values were up to 210 times greater than the USEPA acceptable range for excess risk of cancer. Consequently, it is imperative to implement a strategy to reduce exposure to carcinogenic compounds in the area in order mitigate cancer and non-cancer risks within this mining area.