PurposeMalaysians are the highest seafood consumers in the region; be it fresh or processed. Environmental pollution has put the safety of seafood at stake, heavy metals among others. This study was done to assess the health risk associated with selected heavy metals ingestion from processed seafood.Design/methodology/approachThe most preferred processed seafood type and the intake rates were determined from a cross-sectional survey among communities in Shah Alam, Selangor (n = 90). The processed seafood were then purchased from local traders (n = 81), underwent homogenization, acid digestion (0.5 g) in Multiwave 3,000 and heavy metal quantitation (Hg, Pb, Cd, As) using ICP-MS. Estimated weekly ingestion (EWI), hazard quotient (HQ), hazard index (HI), lifetime cancer risk (LCR), and target risk (TR) were used to estimate the risk associated with processed seafood consumption.FindingsArsenic was the highest metal detected, acetes topping the list (10.05 ± 0.02 mg/kg). Mercury was detected at significantly higher level in salted fourfinger threadfin (0.88 ± 0.09 mg/kg) while Pb and Cd in toli shad (2.67 ± 0.16 mg/kg; 0.32 ± 0.22 mg/kg). Non-cancer risk was estimated for consumption of dried/salted food types with hazard index (HI) anchoives (5.2) > salted fourfinger threadfin (1.8) > toli shad (1.7). Besides, an unacceptable cancer risk was estimated for all food types for continuous consumption (Total risk (TR) > 10–4), except the dried acetes.Research limitations/implicationsThis study implies that although the concentration of most heavy metals were well below the permitted value, significant amount of risk present for consumption of several species. In addition, for selected heavy metals such as Hg and As, speciation analysis followed by risk assessment would provide a clearer picture.Practical implicationsThere is a need to refer back to the local permissible level of heavy metals in processed seafood and formulate safe consumption guide.Social implicationsThe food types are advised to be consumed with caution especially by the sensitive group.Originality/valueThis study estimated the risk of cancer and other non-cancer disease from processed seafood consumption among Malaysian women.