Goat milk is a culturally and nutritionally significant food worldwide, yet its safety regarding toxic and trace elements remains poorly defined. The absence of geographically balanced surveillance and the variability in contamination across rural, urban, and industrial environments limit reliable risk assessment for human exposure. We hypothesized that raw goat milk acts as a sentinel matrix for chronic exposure to toxic and potentially toxic elements, with risks strongly influenced by production systems and environmental contexts. Accordingly, the objective of this review was to systematically synthesize evidence from 20 studies conducted across Asia, Europe, and North Africa, quantifying toxic metals (arsenic, lead, cadmium, and mercury) and essential elements (chromium, nickel, copper, zinc, iron, manganese, and aluminum) relative to thresholds established by the World Health Organization (WHO), the European Food Safety Authority (EFSA), and the Institute of Medicine (IOM). Results revealed pronounced heterogeneity, with lead reaching 0.382 ± 0.0026 mg/L in rural Algeria, chromium peaking at 16.423 ± 0.349 mg/L in industrial Asaluyeh and 14.211 ± 0.205 mg/L in rural Kaki, Iran, and pediatric estimated daily intakes (EDIs) for Cr up to 2.74 × 10 mg/L body weight/day, whereas target hazard quotients (THQs) and hazard index (HI) values exceeded safety thresholds by up to two orders of magnitude. These findings demonstrate that raw goat milk is a heterogeneous yet consistent vector of chronic exposure to toxic elements, demanding harmonized monitoring frameworks, regionally adapted regulatory standards, and integrated risk assessments coupling chemical surveillance with agroecological and public health strategies.