Coastal areas serve as vital ecosystems that provide habitats for various organisms but are increasingly threatened by trace element pollution. This study examines trace element concentrations in water, fish, and shellfish from estuarine and coastal areas of Bangladesh's East Coast, evaluating their associated human health risks. The mean concentrations of all trace elements in surface waters of the East Coast were in the following descending order: Zn > Cu > As > Pb > Cr > Cd and all of the values were much higher than the guideline values. The mean concentrations for As, Pb, Cd, Cr, Ni, Cu and Zn for fish and shellfish were 0.42, 2.18, 0.6, 2.16, 0.68, 5.19 and 84.6 μg/g, respectively. Total value of estimated daily intake (EDI) for As, Pb, Cd, Cr, Cu and Zn were 3.108, 2.294, 0.874, 0.750, 5.856 and 31.36 mg/day, respectively. Most EDIs, except for As and Cu, were below tolerable limits. Total value of target hazard quotient (THQ) for As, Pb, Cd, Cr, Cu and Zn were 172.67, 10.924, 4.856, 0.0083, 2.4401 and 1.7421, respectively that suggested a higher level of potential non-carcinogenic health risk since THQ value is >1 except Cr. The target cancer risk (TR) value of As, Pb, Cd and Cr are ranged from 1.12E-04 to 1.39E-02, 1.87E-06 to 1.13E-04, 6.83E-05 to 1.13E-03 and 6.49E-05 to 1.05E-03, respectively. The TR values of As, Cr, and Cd in most studied fish exceeded the reference value (10-4), indicating a potential lifetime cancer risk for consumers. Immediate environmental interventions are essential to mitigate pollution and achieve sustainable development goals.