The aims of the present study were to obtain the seafood dietary patterns of coastal residents, to determine the concentrations of heavy metals, and to evaluate the possible health risks caused by seafood intake. The daily food intakes of 24 types of seafood were collected from 738 participants from Xiamen, a southern Chinese coastal city, using food frequency questionnaire (FFQ) and dietary history method. One hundred and fifty-six samples of 14 types of highest intake seafood were collected from local markets for lead (Pb), cadmium (Cd), chromium (Cr), mercury (Hg), and arsenic (As) determination. Health risks via seafood consumption were evaluated by calculating the target hazard quotient (THQ) and the total hazard index (HI) for carcinogenic and non-carcinogenic effects recommended by the US Environmental Protection Agency. The results showed that the seafood daily intake of Xiamen residents was 61.5 (2.14, 115) g/day. The concentrations of Pb, Cd, Cr, Hg, and As in seafood were ND-0.45 mg/kg, ND-0.19 mg/kg, ND-0.80 mg/kg, ND-0.70 mg/kg, and 0.32-16.9 mg/kg, respectively. Concentrations of Cd and As in some samples were higher than national limitation standards. Consumption of 14 common types of seafood would not pose non-carcinogenic risk. However, some types, such as sparuslatus, oyster, and porphyra tenera, would form a carcinogenic risk. Regardless of a carcinogenic or non-carcinogenic risk, As posed the highest risk on humans. The observed HI value for non-carcinogenic effect of all metals in all seafood reached 0.69-2.20, and the metal orders of risk can be listed as As > Hg > Cr > Cd > Pb, reiterating the risk of As is a matter of concern in seafood from Xiamen markets.