The aim of this study was to provide information on the levels of toxic (Cd and Pb) and essential (Cu, Fe, and Zn) elements in cow’s milk produced in the State of Pernambuco (Brazil). A total of 142 samples of raw milk were collected, and the concentrations of essential and toxic elements were determined using inductively coupled plasma-optical emission spectrometry. In almost 30% of the samples analyzed, the Pb content exceeded the maximum level established in the Brazilian legislation (0.05 mg/L). By contrast, in all the samples, the Cd content was below the maximum allowable level (0.02 mg/L). The essential trace elements Cu, Fe, and Zn were generally present at lower concentrations than reported in other studies and can be considered within the deficient range for cow’s milk. Statistical and chemometric procedures were used to evaluate the main factors influencing the metal concentrations (proximity to major roads, presence of effluents, and milking method). The study findings demonstrate that the proximity of the farms to major roads influences the concentrations of Cd, Pb, and Cu and that this is the main factor explaining the Pb content of milk. In addition, the presence of effluents influenced the concentrations of Cu, while no relationship between the metal content and the milking method was observed. Thus, in accordance with the study findings, the consumption of cow’s milk produced in the region can be considered a risk to public health due to the high concentrations of Pb and the low concentrations of other essential minerals such as Cu, Zn, and Fe in some of the milk samples.