Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous environmental pollutants that possess serious risks to human health and the environment. Forty riverbed sediments samples were collected in mangrove river bed sediments where artisanal refining of crude oil takes place in the Niger Delta of Nigeria. The concentration, occurrence, distribution, toxicity and health risk of sixteen priority PAHs (16PAHs) were analysed in the samples. Apart from Nap, Acy, BkF, InP and DbE, all the other PAHs were present in all the sampled points of the studied area with BbF and BaA recording the highest mean values. The range and mean of the total PAHs (∑16PAHs) of this study are 23.461–89.886 mg/kg and 42.607 ± 14.30 mg/kg dry weight (dw), which is classified as heavily contaminated when compared to the European classification of PAHs pollution in soil (>1.0 mg/kg). The range of the effect range factors used to assess the risk of PAHs in an ecosystem (Effect rang-low (ER-L) and Effect range-median ER-M) of this study is from 0.953 to 8.80 mg/kg. PAHs below ER-L (4.0 mg/kg) indicate no toxic effect, but values above ER-M (44.79 mg/kg) indicate toxic effects to the sediments, its resources and, ultimately, the public that consumes the resources thereof; hence, the study area falls within the contaminated category. The occurrence of the high molecular weight (HMW) PAHs (73.4%) supersedes those of the lower molecular weight (LMW) PAHs (26.6%). The diagnostic ratios and principal component analysis suggest that the main contributors of PAHS into the sediments are the combustion of biomass, fossil fuel (crude oil) and pyrogenic sources. The toxic equivalent quotient (TEQ) and mutagenic equivalent quotient (MEQ) of PAHs ranged from 2.96 to 23.26 mgTEQ/kg dw and 4.47 to 23.52 mgMEQ/kg dw, and the total mean toxic equivalency quotient (∑TEQ) (15.12 ± 8.4 mg/kg) is also greater than the safe level of 0.6 mg/kg, which indicates high toxicity potency. The mean incremental lifetime cancer risks (ILCRs) of human exposure to PAHs shows that both adults TotalILCR adults (6.15 × 10−5) and children TotalILCR children (2.48 × 10−4) can be affected by dermal contact rather than ingestion and inhalation. Based on these findings, the appropriate regulatory bodies and other organs of government in the region should enforce outright stoppage of the activities of these illegal artisans who do not have control mechanisms for loss control at the site and carry out appropriate clean-up of the area.