The presence of artisanal and small-scale gold mining (ASGM) in Indonesia has led to adverse environmental and human health impacts due to the use of mercury in ore processing. Unlike previous similar studies on ASGM in Indonesia, this study employed a quantitative approach involving a larger and more representative group of participants. It combined hair and urine biomarkers according to exposure pathways to analyze individuals' total mercury exposure. This study applied a health-related quality of life (HRQoL) assessment using the EQ-5D-5L and VAS instruments for the first time in the Indonesian ASGM population. Additionally, it examined the correlation between socio-economic factors and mercury exposure. The study was carried out in three ASGM sites in Ciemas, Waluran, and Lengkong subdistricts, Sukabumi Regency, from October 2023 to August 2024. This research determined the sample size (n = 400) through simple random sampling using the Slovin formula at a 95% confidence level. The results showed the average mercury level in hair was 1.67 μg/g, with 43.5% of respondents in the “alert” to “high” categories based on WHO reference values. In urine, the average level reached 35.81 μg/L, with 74.75% of respondents exceeding the HBM2 reference values. No significant difference was found between miners and non-miners, indicating widespread environmental exposure. In addition, the standardized HRQoL instruments showed that while over 72% of respondents rated their health as good, at least 30% reported physical discomfort, and 20% experienced emotional issues. A more in-depth health assessment also revealed that respondents experienced several symptoms or health issues consistent with mercury toxicity, including muscle cramps, headaches, respiratory problems, and internal organ disorders. Correlation analysis revealed a weak but significant association between monthly income and mercury levels in hair. Among miners, longer work duration also correlated significantly with higher mercury exposure. The findings underscore the need for comprehensive interventions that target both environmental control and community health protection in ASGM area. © 2025 The authors. This article is published by IIETA and is licensed under the CC BY 4.0 license (http://creativecommons.org/licenses/by/4.0/).