Lead (Pb) and cadmium (Cd) contamination in drinking water represents a continuing global public health concern. These toxic metals persist in the environment, lack biological utility, and accumulate in the human body, posing long-term health risks. Children are especially vulnerable due to their higher rates of absorption and developing organ systems. This review synthesizes current knowledge on the occurrence, sources, and pathways of lead and cadmium in drinking water, with particular emphasis on their toxicological effects in children. It also compares international guidelines, summarizes health risk assessment approaches, and identifies gaps in monitoring and mitigation strategies. Evidence shows that exposure to lead in drinking water is strongly linked to neurodevelopmental deficits, anemia, and renal dysfunction, whereas cadmium primarily affects renal and skeletal systems. Despite international regulatory standards, exceedances are widely reported, particularly in low- and middle-income countries with limited monitoring capacity. Future efforts should focus on low-cost monitoring tools, integrated risk assessment frameworks, and stricter policy enforcement to safeguard child health.
