Fine particulate matter (PM2.5) in the atmosphere is of particular concern due to its adverse effects on human health and its impact on global warming. southeast Asia is a hot spot for fossil fuel combustion with recurrent release of large plumes spreading over the ocean and neighbouring countries. Due to the complex mixture of PM2.5, the atmospheric sources contribution related to local and regional emissions in Hanoi (northern Vietnam) is still ill-constrained. Here, we present a year-round study (November 2019 to December 2020) with measurements of 18 metals and metalloids (MM) and lead isotopes in the PM2.5 fraction to quantify weather-related atmospheric inputs and to assess risk to human health. Anthropogenic inputs from fossil fuel combustion accounted for about 80% in PM2.5. We found high PM2.5-bound MM concentrations often exceeding national and global standards with a low risk of chronic inhalation and carcinogenicity, mainly attributable to Cr. During winter monsoon (northeastern winds), stable weather conditions led to the enrichment of long-range air mass transport of local particulate emissions. During the summer monsoon (southeastern winds), warm and moist winds reduced coal contribution in PM2.5. Our study highlights the need for a strict implementation of policies to control hazardous MM emissions by reducing fossil fuel combustion. On the one hand, reducing coal-related activities could reduce Cr emissions and therefore improve the risks to human health. On the other hand, public policies should encourage conversion to green transport in order to reduce petrol combustion and thus limit global warming.