124 road dust samples were collected from an urban area of Shenyang, a typical heavily industrial city in Northeast China, to study the concentration, pollution level, source, spatial distribution, and health risk of heavy metals. The average concentrations of Cd, Cr, Cu, Mn, Ni, Pb, and Zn were 1.802, 132.1, 60.33, 778.3, 54.80, 86.73, and 391.2 mg/kg, respectively. The levels of metal pollution ranged from minimal to extremely high, with average levels in the ranked order: Mn < Ni < Cr < Cu < Pb < Zn < Cd, indicating that the road dust was heavily polluted by Cd, Zn, and Pb. Source identification results demonstrated that Cr, Mn, and Ni had mixed sources including industrial emissions and weathering of soil, pavements, and building materials, while Cu, Pb, and Zn mainly originated from traffic and industrial activities, and Cd had a complex mixture of sources (with various anthropogenic sources). Hotspots of heavy metal pollution levels were closely correlated with local anthropogenic activities, such as industrial discharge, traffic-related exhaust emissions, and agricultural activities. Furthermore, health risk assessment revealed significant non-carcinogenic risks for children from multiple metals, and the carcinogenic risk assessment identified significant risks for children from Cd, with ingestion being the main exposure pathway for carcinogenic and non-carcinogenic risk for adults and children. However, no health risk was observed due to dermal and inhalation exposure pathways.