Urban street dust acts as both a sink and a secondary source of potentially toxic elements (PTEs), contributing to environmental contamination and air quality degradation. Using geochemical and statistical methods, this study aimed to investigate the concentrations, spatial distribution, ecological risks, sources, and associated health risks of selected PTEs (Al, As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn) in < 63 μm street dust samples collected from 29 locations across Istanbul, Türkiye. Elemental concentrations were determined using ICP-MS, and contamination was evaluated using geo-accumulation (I_geo), enrichment (EF), contamination (CF), potential ecological risk (PERI), and Nemerow’s pollution indices (NPI). Positive Matrix Factorization (PMF) identified three dominant sources: industrial runoff (39.4%), traffic emissions (31.3%), and natural/soil inputs (29.4%). Health risk assessments indicated ingestion as the primary exposure pathway. Monte Carlo simulation revealed that the 95th percentiles of THI (3.57) and TCR (2.61 × 10⁻⁴) exceeded recommended thresholds for children, indicating potential non-carcinogenic and carcinogenic risks, while adult risks largely remained within acceptable limits. Traffic-related elements such as Pb, Cu, and Zn were the major contributors to non-carcinogenic risks, with additional implications for inhalation exposure through dust resuspension. Although the Air Quality Index (AQI) remained below 50, suggesting generally good atmospheric conditions during the study period, localized dust contamination was found to pose significant health risks. These findings emphasize the need for integrated mitigation strategies, including traffic emission controls, dust suppression, and urban greening, to minimize PTE exposure and enhance urban environmental health.