Fish is a rich source of proteins for humans and is widely consumed in various places in the world. This study assessed the levels of twenty trace metals (B, Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Sn, Sb, Ba, Hg and Pb) in fish feeds (n = 2), water (n = 27), and edible muscles of Oreochromis mossambicus (n = 20 from 8 ponds) from fish farms and Luvuvhu River (n = 3 from 1 river site) in Vhembe district of Limpopo Province, South Africa. Physicochemical parameters of water in the study area were analysed. Temperature ranged between 21.4-30.47 °C, pH: 5.59-7.28, electrical conductivity: 608-1216 μS/cm, total dissolved solids: 156-675 mg/l, dissolved oxygen: 0.28 - 0.56 mg/l, turbidity: 3.92-356.7 NTU, respectively. Levels of most trace metals such as Cr (2 μg/l and 1000 μg/kg), Mn (100 μg/l and 500 μg/kg), Fe (10 μg/l and 300 μg/kg), Ni (20 μg/l and 100 μg/kg), As (50 μg/l and 3 μg/kg), Pb (10 μg/l and 300 μg/kg) and Cu (2 μg/l and 2250 μg/kg) in water and O. mossambicus muscles were mostly below the World Health Organization (WHO), Food and Agricultural Organization (FAO)/WHO and European Commission (EC) recommended limit in the collected samples (Tshifulalani site and Duthuni site). However, Cu and Fe recorded concentration above the recommended limit at the control site (Luvuvhu River) in water and O. mossambicus muscles, respectively. Results from the bioaccumulation factor (BF), suggests the presence of metals in the water which can bioaccumulate in the fish muscles. Most of the metals (As, Cd, Hg, Mo, Sr, Sb and Sn) that recorded no possible bioaccumulation also recorded levels that complied with their maximum permissible limit (MPL) of WHO, FAO/WHO and EC guideline values in the fish feeds except for Se and Co. Moderate bioaccumulation was recorded for Cr, Mn, Fe and Zn in some of the sampling sites. Pb and Ni showed extreme bioaccumulation (BF > 5000) in one of the sampling sites and also recorded elevated levels in the fish feeds. Average daily dose (ADD), hazard quotient (HQ) and total hazard quotient (THQ) computed were less than 1. The Cancer risk (CR) evaluated were all below 10-4 except in one site for children (Tshifulanani 2) but the overall average result showed no carcinogenic health risk to the consumers of the O. mossambicus. Therefore, O. mossambicus intake in the study area should be constantly monitored to prevent future health implications.