Potential health risks of contaminated media linked to bioavailability and hematotoxicity of uranium-238 ( 238 U) and thorium-232 ( 232 Th) remain uncertain. This study investigates the relative bioavailability (RBA), histopathological, and hematological effects of acute oral exposure to 238 U and 232 Th in cocontaminated concrete dust using 174 female Sprague Dawley (SD) rats. In order to create a range of 238 U and 232 Th concentrations, concrete was spiked with uranyl and thorium nitrates (~ 50, 100, and 200 mg kg −1 ). Spiked concretes were then crushed, ground, sieved (≤75 µm), and blended uniformly to create co-contaminated concrete dust. SD rats' diet pellet was amended with co-contaminated concrete dust and orally ingested over a 48-hour exposure period. The RBA values of 238 U and 232 Th in post-exposure rats' blood were determined as 22.0% ± 0.86% -30.8% ± 1.01% and 11.8% ± 0.14% -13.7% ± 0.29%, respectively. Compared to 232 Th, 238 U blood levels of SD rats fed with co-contaminated concrete dustamended diets were ~ 100-fold higher due to solubility differences, and 238 U-RBA values were approximately two-fold greater, revealing that their absorption rates in the gastrointestinal tract were affected by compound solubility. Post-acute 238 U and 232 Th ingestion from co-contaminated concrete dust demonstrate noticeable histopathological and hematological alterations, implying that intake of 238 U and 232 Th in co-contaminated concrete dust can lead to erythrocytes damage and elevated hematological attributes. Our study would be bene cial for an adequate understanding of the health implications caused by the acute oral exposures of 238 U and 232 Th in co-contaminated concrete dust, especially in the bioavailability and toxicity assessment.