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Accumulation of metals (Fe, Zn, Cu, Mn, Pb, Cd and Ni) in the muscles and gills of Oreochromis niloticus, Oreochromis aureus and Tilapia zillii was assessed based on seven locations in the Qahr El-Bahr area in Lake Al-Manzalah. The average accumulation of metals was in the following order: Tilapia zillii > Oreochromis aureus > Oreochromis niloticus. To determine the risk of fish consumption, the estimated daily intake, carcinogenic, non-carcinogenic and relative risk indices were calculated. The results indicate that the intake of individual metals through the consumption of fish is almost safe for human health, whereas the intake of combined metals poses a high potential health risk to consumers. Assessment of carcinogenic risk of Cd and Ni from the consumption of tilapia species indicates that consumers are at risk of cancer. The contribution of Pb and Cd to the overall relative risk index ranged from 34% to 41%. Of the three species studied, Oreochromis niloticus is relatively safe for consumption as it poses the least health hazard, while Tilapia zillii is more predisposed to accumulate metals in its tissues. Histopathological changes were observed in the muscles, gills and liver of Oreochromis niloticus as a result of heavy metal accumulation in these organs.