Heavy metal contamination near mining sites poses serious and long-term risks to environmental integrity and public health. This study investigates the concentrations, spatial distribution, and geochemical behavior of cadmium (Cd), chromium (Cr), vanadium (V), and antimony (Sb) in soils surrounding the Graçanica tailings dump in Kosovo, a site historically affected by decades of Pb-Zn ore processing. Soil samples were collected from residential and adjacent areas using standardized protocols and analyzed via inductively coupled plasma–optical emission spectrometry (ICP-OES) at the Horn & Co. Analytics SH.P.K. Laboratory in Pristina. Measured concentrations ranged from 4.5–8.6 mg/kg for Cd, 139–783 mg/kg for Cr, 45–89 mg/kg for V, and 4.3–31 mg/kg for Sb, all exceeding permissible limits set by Kosovo, the EU, and WHO/FAO soil quality standards. Spatial analysis revealed peak concentrations near the tailings dump and the Graçanica River, with a declining gradient away from the source—indicating localized pollution from mining activities. Soil pH ranged from 3.95 to 7.73, suggesting that acidic conditions enhance metal mobility and bioavailability. Correlation and pH analysis showed that Cd and Sb exhibit high mobility under acidic conditions, while Cr and V display redox-sensitive behavior, reflecting complex geochemical interactions and multiple contamination sources. These findings highlight the need for targeted remediation, sustained environmental monitoring, and comprehensive health risk assessments. This study also highlights the persistent legacy of mining pollution in Kosovo and contributes critical data for sustainable land management and policymaking.