The use of plant-based therapeutics dates back centuries, yet concerns about the presence of toxic metals in the formulations have raised significant health and safety issues. With the rising cost and limited effectiveness of allopathic medicine, herbal drugs are gaining popularity, particularly in developing countries. However, frequent detection of toxic metals such as arsenic, mercury, lead, and copper in herbal products, often exceeding safety limits, has heightened concerns regarding their health risks. These metals disrupt cellular redox homeostasis by generating reactive oxygen species (ROS), leading to oxidative stress, lipid peroxidation, protein modifications, and DNA damage. Toxic metals enter herbal products primarily through contaminated soil, irrigation water, and poor manufacturing practices. Some metals are intentionally added to enhance the perceived efficacy of herbal drugs, further increasing health risks. Identifying contamination sources is critical for implementing targeted interventions to minimize exposure. Health risk assessments play a crucial role in evaluating the levels of metal contamination, identifying potential hazards, and ensuring consumer safety. This review explores the pathways through which toxic metals enter herbal formulations and their health risk assessment models. By assessing contamination risks and identifying pollution sources, this study aims to guide policymakers and researchers in safeguarding public health and ensuring the safety of herbal medicines.