Heavy metal(loid) (HM) pollution in urban topsoil seriously endangers the health of urban residents and urban sustainable development. Compared with large cities, the research on the HM pollution of topsoil in emerging medium-sized industrial cities is quite limited. This study focuses on topsoil HM contamination in Mianyang, which is a representative moderate emerging industrial city in Southwest China. The results indicate that Ba, Cr, Cu, and Zn in the samples were much higher than their background values. The hot spots of Ba, As, Cu, Pb, Co, Cr, and Zn showed an obvious enrichment trend. The potential ecological risk of HMs showed a low ecological risk, which was mainly caused by As. The investigated HMs presented no significant non-carcinogenic hazard to local adult residents, but there were three sampling sites which presented a non-carcinogenic hazard to children; the carcinogenic risks of As, Cr, Co, and Ni were acceptable. In this study, a mixed source of industry and traffic was identified to be the priority anthropogenic source, and Cr and As were identified as the priority elements for further risk control. The findings of our study could be beneficial to decision-makers with regard to taking appropriate measures to control and reduce HM pollution in the Mianyang urban area.