This study analyzed the sources of total metal elements using the positive matrix factorization (PMF) model and conducted human health risk assessment for adults and children using the health risk assessment model recommended by the United States Environmental Protection Agency (USEPA). According to the health risk assessment, As is the main contributor to the non-carcinogenic risk of groundwater in Tengzhou, with drinking water as the main exposure route. Regarding carcinogenic risks (CR), the values of As and Cr for adults and children were higher than 1 × 10−4, with drinking water as the main exposure route. Therefore, As is the largest contributor to the CR of groundwater for adults and children and drinking water is the main exposure route in the study area. The primary exposure pathways are oral intake and dermal contact, with oral intake presenting a significant risk. The carcinogenic risks according to principal component analysis (PCA) and PMF analysis showed that the main sources of heavy metals in shallow groundwater in Tengzhou City are agricultural, industrial, natural, and industrial deposition sources, with contribution rates of 21.7%, 27.2%, 31.0%, and 20.1%, respectively. In particular, natural sources are the largest contributor to the accumulation of heavy metals.
