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This systematic review (PRISMA compliant) synthesizes evidence from 32 studies (2015\u20132025) elucidating toxicity mechanisms via oxidative stress, inflammation, endocrine disruption, and epigenetic dysregulation. Key biomarkers\u2014blood\/urinary metal levels, oxidative stress markers (8\u2010OHdG and MDA), and inflammatory cytokines (CRP, IL\u20106, and TNF\u2010\u03b1)\u2014enable early detection and toxicity assessment. Pro\u2010inflammatory responses dominated across studies, with Pb and Cd consistently elevating CRP, TNF\u2010\u03b1, and IL\u20106, alongside tissue\u2010specific inflammation (liver and kidneys). ELISA emerged as the primary analytical method, although biomarker variability underscored influences of dose, duration, and individual susceptibility. Critically, anti\u2010inflammatory IL\u201010 was frequently downregulated. We highlight the clinical utility of biomarkers in public health surveillance, chelation therapy, and preventive strategies. Future directions prioritize omics\u2010based profiling, CRISPR technology, portable biosensors, and standardized protocols for real\u2010time monitoring and personalized risk assessment. 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