<p>This article critically examines uranium mining as a global public and environmental health crisis, rather than merely a technical or industrial activity. It discusses how extractive operations produce cumulative, long-term harms ranging from radioactive exposure and ecological degradation to intergenerational health risks that fall most heavily on communities already marginalised by social and political inequalities. Drawing on the secondary sources of data and illustrative case studies, including those from Indigenous territories, it maps the deeply uneven distribution of risks and benefits across the uranium supply chain. These cases reveal how uranium extraction magnifies environmental injustice by (re)producing inequitable exposures, limiting community participation and denying recognition to affected peoples. We also interrogate the ethical pressure at the heart of contemporary sustainability debates: the promotion of nuclear energy as a climate solution while ignoring the toxic material realities on which it depends. As both a critical synthesis and a call for systemic reform, we argue for justice-oriented policies grounded in public health equity, environmental responsibility and genuinely participatory governance. Ultimately, rethinking uranium mining requires more than technological improvements; it demands confronting the structural injustices rooted in extractive economies and centring the lived experiences, rights and knowledge systems of the communities who bear the greatest burdens.</p>