The objective of the present study was to integrate the relative risk from mercury exposure to stream biota, groundwater, and humans in the Río Artiguas (Sucio) river basin, Nicaragua, where local gold mining occurs. A hazard quotient was used as a common exchange rate in probabilistic estimations of exposure and effects by means of Monte Carlo simulations. The endpoint for stream organisms was the lethal no-observed-effect concentration (NOECs), for groundwater the WHO guideline and the inhibitory Hg concentrations in bacteria (IC), and for humans the tolerable daily intake (TDI) and the benchmark dose level with an uncertainty factor of 10 (BMDLs(0.1)). Macroinvertebrates and fish in the contaminated river are faced with a higher risk to suffer from exposure to Hg than humans eating contaminated fish and bacteria living in the groundwater. The river sediment is the most hazardous source for the macroinvertebrates, and macroinvertebrates make up the highest risk for fish. The distribution of body concentrations of Hg in fish in the mining areas of the basin may exceed the distribution of endpoint values with close to 100% probability. Similarly, the Hg concentration in cord blood of humans feeding on fish from the river was predicted to exceed the BMDLs(0.1) with about 10% probability. Most of the risk to the groundwater quality is confined to the vicinity of the gold refining plants and along the river, with a probability of about 20% to exceed the guideline value.