Many rural communities in Mozambique get their income from fisheries, as well as consume fish as an inexpensive source of protein. In Mozambique, fish consumption from small-scale fisheries dependent families can range between 60 and 150 kg/person/year. Anguillid eels have important social value to vulnerable local communities in the Incomati Basin. Anguillid eels in the lower Incomati Basin are targeted for consumption, as well as cultural rituals by traditional healers. The aim of the present study was to determine trace element concentrations in environmental matrices, bioaccumulation patterns in muscle and liver tissue of two Anguilla species (Anguilla mossambica and Anguilla marmorata), as well as the chronic health risk these elements pose to regular consumers in the lower Incomati River. Bioaccumulation of elements from the water had a higher effect on both muscle and liver tissues, where only the bioaccumulation of Pb in the sediments played a major role. From the human health risk assessment, Hg pose non-carcinogenic risk, whereas As, Cr, and Ni pose carcinogenic risks.