<p>Shiyan City, located in the mountainous hinterland of the Qinba Mountain Range, China, is a rapidly urbanizing region where shallow groundwater plays a crucial role in supporting residential needs. However, the quality of this vital resource is increasingly threatened by both natural factors and human activities, making it essential to understand the current status of groundwater quality and associated health risks. This study assessed the hydrochemical characteristics and health risks of shallow groundwater in Shiyan City using 60 samples analyzed for major ions and trace elements. Groundwater quality was assessed using the Water Quality Index (WQI), while health risks associated with shallow groundwater were evaluated using the Hazard Index (HI). The results showed that the groundwater was primarily of the Ca·Mg–HCO₃ type, with major contaminants such as total phosphorus (TP), Mn, and Pb present at levels exceeding national drinking water standards. The WQI evaluation indicated that 83.33% of the samples were classified as excellent or good for drinking purposes, while 16.67% fell into fair, poor, or very poor categories. However, the HI revealed that 61.67% of samples posed potential non-carcinogenic health risks, particularly due to elevated concentrations of TP, F^-, and Pb, with high-risk regions primarily located in northern Zhuxi, northwestern Zhushan and Fangxian. The findings emphasize the need for targeted risk management strategies to ensure the safety of groundwater resources, particularly addressing TP, which represents a significant threat to public health. This research provides a critical basis for water resource management and health risk prevention in Shiyan City and similar mountainous regions globally.</p>