The levels and distribution of trace metals (Cr, Mn, Co, Ni, Cu, Zn, Cd and Pb) at eleven water and sediment stations on the Little Akaki River (LAR) in Addis Ababa, Ethiopia, were determined. The binding forms of the metals in various geochemical fractions of the sediments were also quantified. The molar ratio of the sum of the simultaneously extractable metals (∑SEM) and acid-volatile sulphide (AVS)-as a measure for predicting metal-induced toxicity-was estimated. LAR trace levels in water for Cu, Zn, and, particularly Mn were, in most instances, higher than the recommended guidelines for healthy aquatic ecosystems. Total trace metal (TTM) contents in the LAR sediments at certain stations exceeded "threshold effect concentrations" and even "probable effect concentrations", especially in the cases of Zn, Cu, Ni, Pb, and at all stations for Mn. This became more apparent after applying "normalizations" to the relatively lower TTM adsorption capacities of coarse-grained, organic-poor sediments. Sequential extraction of the sediments showed that trace metals generally have a higher affinity for Fe-Mn oxide and organic matter/sulphidic fractions, followed by the residual fraction. Mn was relatively strongly bound to the exchangeable, carbonate bound fractions, whereas a large proportion of Cr was found in the residual fraction. The Σ[SEM]/[AVS] ratio pointed to potential metal-induced toxicity of sediments collected from seven out of the eleven stations. The results indicate that trace metal pollution pose risks to the health of ecosystems, and to human communities that use the river for a range of different purposes.