Heavy metal (HM) pollution in sediment is a serious conc particularly in developing nations, war-ranting an extensive survey to understand the current situation and propose possible remedial measures. This paper compiles the data of HMs cadmium (Cd), iron (Fe), cobalt (Co), manganese (Mn), arsenic (As), lead (Pb), chromium (Cr), copper (Cu), zinc (Zn) and nickel (Ni) in aquatic sediment from India from 1979 to 2017. It was found that mean values of Cu, Co, Zn, Pb, As, and Cr in Indian sediment were high in comparison to the Australian Interim Sediment Quality Guidelines, World Surface Rock Average, and the Threshold Effect Level for freshwater ecosystems. Anthropogenic activities, lithogenic factors, and sand intrusion are the main factors associated with HM pollution as observed using cluster analysis and principal component analysis. The results of contamination indices indicate that HM contamination ranged from average to high, in the sediment. The ecological risk assessment results showed that 11％HMs present very high risk. The cancer risk, due to the high contents of Cd, As, and Cr the ingestion pathway, showed high risk of cancer through food/water contaminated with sediment. At source reduction of HMs in industrial effluents by effluent treatment plants, and plantation of phytoremediating rooted macrophytes in sediment may help in HM mitigation of the sediment.