Ekondo-Titi and environs are found between 4.500 -4.950N and 8.900 -9.250E onshore Rio Del Rey Basin in Ndian and Meme Divisions of the South West Region in Cameroon. Evaluation of trace metals in groundwater is among the most important environmental issues related to contamination from anthropogenic and natural sources due to increased urbanization and intensive plantation agriculture in Ekondo-Titi and environs. The study investigated the trace metal content of groundwater sources; determined estimates of the health hazard and pollution risk indices; assessed the health hazard and level of risk to trace metal pollution in Ekondo-Titi and environs. Field measurement of physicochemical parameters and analysis of thirty-seven groundwater samples were analyzed to determine their trace metal content using Inductively Coupled Plasma Mass Spectroscopy ICP-MS. R-mode statistical analysis; Hierarchical Cluster Analysis (HCA) and Pearson's correlation analysis (PCA) of the trace metals with the physico-chemical parameters have been carried out. A risk is the chance, high or low, that the exposure to a hazard will actually cause harm. Four pollution hazards were estimated the average daily dose ADD, carcinogenic risks CR, non-carcinogenic risk hazard quotient HQ and hazard index HI. Six pollution risks were determined: the Degree of contamination DC, Enrichment factor EF, Ecological risk factor Er, Ecological risk index RI, Pollution load index PLI, and geo-accumulation index Igeo. The results show that the average abundance of trace metals concentrations in the groundwater is in the order: Fe > Ba > Mn > Zn > Sr > Ni > Cu > Co > Pb > Li > Cr > V > As > Cd. HCA distinguishes the trace metals into two clusters: Cluster one; (01) element Fe; soluble; Cluster two (13) non soluble elements divided into two classes; class one (09) V, As, Cd, Cr, Li, Pb, Co, Ni, C; less enriched; Class two (04) Mn, Ba, Sr and Zn; enriched. PCA shows a very strong positive correlation between Cr/V, Ba/Li, Ba/Mn, Pb/Ni, Pb/Zn, Cu/Zn and a moderately strong correlation between Co/Mn, Ba/Co, Ba/EC and Ba/TDS. The values of groundwater pollution hazard indices range as follows; ADD (5E-06 -0.078), CR (4.3E-06 -0.002), HQ (3E-04 -1.23) and HI (0.03 -1.23). And those of the pollution risk indices are DC (−13.59 to −5.62), EF (0.79 -843.94), Er (−29.84 -0.19), RI (−62.07 to −45.53), PLI (−0.044 -0.046) and Igeo (0 -995.4). The groundwater pollution hazard indices ADD and CR are less than 1 in the categories of insignificant pollution health hazard, are below the acceptable guideline values whereas HQ and HI are above 1, likely to pose health hazards. The pollution health risk indices DC, EF, Er, RI, PLI, and Igeo are all below the acceptable guideline values. The enrichment factor EF showed that the sources of these metals are geogenic and anthropogenic processes. Barium is the most enriched element in the study area; this could be attributed to agricultural fertilizers. Igeo values indicate groundwater is no pollution to moderately pollution risk from...