The degradation of sediments in urban environments worldwide is driven by population growth, urbanization, and industrialization, highlighting the need for thorough quality assessment and management strategies. As a result of these anthropogenic activities, benzene, toluene, ethylbenzene, xylenes, and styrene (BTEXS) are persistently released into the environment, polluting sediment. This study employed self-organizing maps (SOMs), positive matrix factorization (PMF), and Monte Carlo simulation of source-oriented health risks to comprehensively investigate sediment in an urban shallow lake in a mid-sized city in central Serbia. The results indicated a mean ∑BTEXS concentration of 225 µg/kg, with toluene as the dominant congener, followed by m,p-xylene, benzene, ethylbenzene, o-xylene, and styrene. Three contamination sources were identified: waste solvents and plastic waste due to intensive recreational activities, and vehicle exhaust from heavy traffic surrounding the lake. Both non-carcinogenic and carcinogenic health risks were below the permissible limits. However, children were more susceptible to health risks. Benzene from vehicle exhaust is the most responsible for non-carcinogenic and carcinogenic health risks in both population groups. The results of this study can help researchers to find a suitable perspective on the dynamics and impacts of BTEXS in lake sediments.