Metal contamination in seafood has raised public health concerns, especially for local residents who live in coastal areas. In this study, the levels of cadmium (Cd), lead (Pb), mercury (Hg), and zinc (Zn) were determined in the marine bivalve, Marcia optima, as well as in water, and sediment samples collected from the coastal area of Phuket Bay, Thailand. The results showed that metal concentrations in sediments (4.05–7.14, 16.68–18.13, 164–213 mg kg⁻¹ for Cd, Pb, and Zn, respectively) and water samples (0.16–0.44, 0.15–0.26, and 0.32–0.48 mg L⁻¹ for Cd, Pb, and Zn, respectively) were below the threshold effects concentration of the sediment quality guidelines for adverse effects to occur and the marine water quality standards of Thailand. A human risk assessment was performed and the results showed that the risks associated with M. optima consumption at Saphan Hin and Paklok were negligible for most of the metals studied, with the maximum estimated daily intake value being observed for Zn (0.00663 mg kg⁻¹ per day) at Saphan Hin. In addition, Cd, Zn, Pb, and Hg would be unlikely to pose a risk to human health with a hazard quotient of less than 1, with only the bioaccumulation factor of Zn being detectable in both locations (0.034 and 0.026 at Saphan Hin and Paklok, respectively). However, continuous monitoring is encouraged to prevent the risks associated with the consumption of metal-contaminated seafood.