The physical disturbance of rivers can degrade water quality, fish populations, food chains, and safety. Using Malaysia as a case, this study aims to protect ecosystems by determining heavy metal concentrations in freshwater fish from Bukit Goh, Kuantan, assessing health risks for local communities consuming these fish and developing a regression model of heavy metals in fish using water quality parameters. Water and fish samples were collected and analyzed for heavy metals using ICP-MS. A community health risk survey was conducted, with data analyzed using PCA and MLR. Results displayed Kuantan River as slightly polluted (Class II) while Riau River and Pinang River as heavily polluted (Class III). Heavy metal concentrations were the highest for Fe and Al in water and fish. Meanwhile, HQ values for Al (3.558) and Fe (1.935) exceeded safe levels, indicating potential health risks. The regression model accurately predicted heavy metal accumulation in fish, aiding in evaluating health hazards from fish consumption.