Abstract: Objective To explore the pollution levels and health effects of heavy metals in fine particulate matter under the weather conditions (air quality index,AQI> 200) of Tianjin in 2016. Methods Regular sampling of the atmosphere of the winter heating season was conducted in Heping District and Beichen District of Tianjin. A total of 159 samples were collected. Sb, As, Cd, Cr, Hg, Pb, Mn, Ni and Se were identified using a 7 500cx inductively coupled plasma mass spectrometer. Health risk of respiratory exposure to carcinogenic and non-carcinogenic heavy metal was assessed through the United States Environmental Protection Agency health risk assessment model. Results The amount of 41 samples was obtained in 21 days of AQI>200, and 118 samples in 59 days of AQI<200. The average value of the average mass concentration of 0.588 mg/m³ in December, which was 7.8 times of the national secondary standard concentration limited. The sequence of the concentrations of the nine heavy metals in the two weather lined from high to low was the constant ones:Pb, Mn, As, Sb, Se, Cd, Cr, Ni, Hg. When the AQI> 200, the excess carcinogenic risk of As for adults were 8.62×10^-6 and 9.10×10^-6 in urban and suburban respectively. The range of carcinogenic excess risk for children in urban areas and suburbs was from 3.40×10^-8 to 4.09×10^-6, The non-carcinogenic risk to adults ranged from 9.17×10^-4 to 6.56×10^-2, and the non-carcinogenic risk to children ranged from 1.49×10^-4 to 8.85×10^-2, both less than 1. Conclusion As has the highest health risk when AQI> 200. Relevant departments in the development of risk management policies should pay greater attention.