<p>Mining activities can lead to heavy metal contamination in soils and crops, posing ecological and human health risks. This study assessed heavy metal and nutrient contamination, soil pollution status, bioaccumulation, and associated health risks in cocoyam leaves (Xanthosoma sagittifolium Schott) from three mining-affected communities (Kenyasi No. 1, Kenyasi No. 2, and Ntotroso) and a non-mining site (Wamahinso) in the Ahafo Region, Ghana. Soil and cocoyam leaf samples were analyzed for As, Cd, Pb, and Hg and selected nutrients (Ca, Mg, K, Na, and P) using atomic absorption spectrophotometry, flame photometry, and titration. Soil metal concentrations at mining sites reached up to 89.6&#xa0;mg&#xa0;kg⁻¹ for As and 19.3&#xa0;mg&#xa0;kg⁻¹ for Cd, while cocoyam leaf concentrations ranged from 0.03–0.69&#xa0;mg&#xa0;kg⁻¹ for As and 0.01–0.15&#xa0;mg&#xa0;kg⁻¹ for Cd. A comparative cross-sectional design was used, and a total of 60 soil samples and 60 cocoyam leaf samples (n = 120) were collected across four sites. BAF values were &lt; 1 for all metals, indicating limited transfer of heavy metals from soil to cocoyam leaves. PERI analysis indicated cadmium (Cd) as the dominant contributor to ecological risk (approximately 61–92% of total risk), with mercury (Hg) contributing moderately, while arsenic (As) contributed less than 5%. Human health risk assessment indicated substantial non-carcinogenic risk (THQ and HI &gt; 1) and elevated carcinogenic risk (CR &gt; 1 × 10⁻⁴) at mining sites, particularly for children. The non-mining site showed comparatively lower risks, although some indices marginally exceeded recommended thresholds. Overall, despite limited bioaccumulation, elevated soil contamination in mining areas poses significant ecological and human health risks, underscoring the need for continuous monitoring and risk management in mining-impacted agricultural landscapes.</p> Graphical Abstract <p></p>