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This study collected 1135 topsoil samples of cultivated land in Laiyang County, eastern China, to analyze the distribution, pollution and health risks of heavy metals (As, Cd, Cu, Cr, Hg, Ni, Pb and Zn). The results show that: (1) the levels of eight heavy metals at some sites were higher than the risk screening values in China, and there was heavy metal pollution. (2) An improved geoaccumulation index was used to evaluate soil pollution. The average value of Igeo before and after improvement was 0.32 (Iml, no pollution to medium pollution) and −0.04 (Iol, no pollution), respectively. (3) Hg and Cd were identified as the main contributors to ecological risk in this study, with a cumulative ecological risk contribution percentage > 65%. The results of the potential ecological risk index (PERI) show that 9.3% of the sampling sites were considered to have moderate ecological risk. (4) As, Pb, Ni and Cu made a contribution of >95% in terms of non-carcinogenic risk to adults and children through different exposure routes, and different soil intake routes posed no non-carcinogenic risk to adults; there was a sampling site with HQChildren > 1, which was consistent with the non-carcinogenic risk site, indicating that children in this location and surrounding areas are more likely to face dual health risks. Therefore, it is necessary to promote the risk management of heavy metals in the study area in order to safely use soil resources.