To assess the contamination levels, sources, and ecological health risks of potentially toxic elements (PTEs) in the sediments of Al Lith on the Saudi Red Sea coast, 25 samples were collected and analyzed for Zn, V, Cr, Cu, Ni, As, Pb, and Fe using inductively coupled plasma-atomic emission spectrometry. The average concentrations of PTEs (μg/g) were obtained in the following order: Fe (14,259) > V (28.30) > Zn (22.74) > Cr (16.81) > Cu (12.41) > Ni (10.63) > As (2.66) > Pb (2.46). The average values of enrichment factor were in the following order: As (1.12) > Zn (0.75) > V (0.70) > Cr (0.69) > Cu (0.69) > Pb (0.67) > Ni (0.46). This indicated that the Al Lith sediments exhibited either no or minimal enrichment of PTEs, with concentrations below the low effect range. This suggests that the primary source of these PTEs is the minerals associated with the basement rocks of the Arabian Shield (sphalerite, vanadiferous magnetite, chromite, pentlandite, arsenopyrite, and galena) and that they are unlikely to pose a substantial risk to benthic communities. The hazard index (HI) values for the PTEs in both adults and children were below 1.0, indicating no significant non-carcinogenic risk. The lifetime cancer risk (LCR) values for Pb, As, and Cr in both adults and children were within acceptable or tolerable levels, posing no significant health threats. However, a few samples showed LCR values exceeding 1 × 10−4, which may indicate potential risks.