Background <p>Altered pubertal development is associated with important physical and psychosocial consequences. This study explored the relationship between blood levels of cadmium (Cd), mercury (Hg), manganese (Mn), lead (Pb), and selenium (Se) and hormone-defined pubertal status in children aged 6–14 years using NHANES 2013–2016 data.</p> Methods <p>Data from 2147 participants were analyzed, including serum hormone levels (testosterone for males and estradiol for females), potentially toxic metals/metalloids (PTMs) concentrations, age, sex, body mass index (BMI), waist circumference, and lipid profiles. Pubertal status was defined exclusively by sex-specific hormone thresholds. Logistic regression models, restricted cubic spline analysis, subgroup analyses, and Bayesian kernel machine regression were used to assess associations.</p> Results <p>Cadmium exposure was associated with higher odds of having reached pubertal status in males (OR 3.80, 95% CI: 2.55–5.68, <i>P</i> &lt; 0.0001). Lead exposure was inversely associated with pubertal status in females (OR 0.25, 95% CI: 0.13–0.47, <i>P</i> &lt; 0.001). Manganese and mercury showed weaker associations, with mercury approaching significance in males (<i>P</i> = 0.074). Selenium concentrations were inversely associated with pubertal status, especially in younger children.</p> Conclusions <p>Exposure to cadmium and lead was associated with hormone-defined pubertal status in this cross-sectional study.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>This study demonstrates that blood concentrations of specific potentially toxic metals are associated with hormone-defined pubertal status in U.S. children.</p> </ItemContent> <ItemContent> <p>It adds nationally representative evidence highlighting sex-specific and metal-specific associations, particularly for cadmium and lead, using hormone-defined pubertal status.</p> </ItemContent> <ItemContent> <p>The findings extend existing population-based evidence by integrating complementary single-metal, non-linear, and mixture-based analytical approaches.</p> </ItemContent> <ItemContent> <p>These findings provide epidemiological evidence that may inform future research on environmental metal exposures and pubertal development.</p> </ItemContent> </UnorderedList></p>