People of the littoral region of cameroon live in fragile ecosystem, which undergo a rise in pressure associated with agricultural exploitation, farming and the increasing use of pesticides in agro-industrial crops. This study aimed to evaluate chronic pesticide exposure effects on liver, renal, and neurological function among banana workers in the Moungo Division, Cameroon. A two-phase approach was employed. Firstly, a survey of pesticide distributors, retailers, and local farmers was conducted using a structured questionnaire to identify the different types of pesticides commonly used in the study area and their reported health effects. Secondly, a case-control study was performed comparing banana farm workers with a control group. Blood samples were used to detect pesticides residues and to quantify key markers involved in the liver, kidney and brain function. The most active ingredients used by farmers were paraquat (59.78%) and glyphosate (34.87%) for herbicides, organophosphates (32.92%), followed by Fipronil (13.42%) among insecticides and Mancozeb (34.04%) for fungicides. The most common symptoms reported were eye irritation (26.77%), skins irritation (42.52%) and respiratory problems (8.66%). Pesticide residues analysis revealed that 46.66% blood samples of farm workers contain more than three pesticide residues. ASAT, ALAT, ALP, LDH activities and plasma urea were significantly elevated in farm workers compared to the control group. Moreover, a significant impact in brain health was observed as shown by the decrease in both erythrocyte acetylcholinesterase and plasma butyrylcholinesterase activities of banana farm workers compared to control. The use of pesticide may be associated with liver, kidney and brain dysfunction. This finding suggests that the use of mixture pesticide is a health risk for banana plantation workers.