The lower slope of the Mid-Levels area, Hong Kong, is one the most heavily urbanized coastal areas in the world. A comprehensive groundwater heavy metal and trace element study was conducted in the Mid-Levels area aiming to investigate the impacts of urbanization on the aqueous distributions of these chemicals. Groundwater samples were collected in the upper natural slopes and the lower highly urbanized spaces in the area in different seasons, and analyzed for heavy metal and trace element contents. Compared to the results from natural slopes, groundwater samples in the developed spaces did not exhibit significant elevated levels in Zn, Cr, Cu, Cd, Pb and Fe, which are commonly found in stormwater. On the other hand, the samples were found to have elevated contents in Mn, V, Co and Mo, minor stormwater-related heavy metals, suggesting that stormwater drains may be leaking to some extent. However, the results suggested that the vadose zone could remove many of the heavy metals, protecting groundwater from being contaminated seriously. Statistical analysis suggested that a certain amount of Mn and Co was likely to be re-mobilized from natural soils due to the changes in local redox conditions, while Mn, V, Co and Mo may also be derived from steel corrosion as a result of prolonged submergence. Besides, the average B concentration in the developed spaces was about eight times higher than that in the natural slopes, indicating the presence of sewage. The mean Se concentration in the developed spaces was about 100 times higher than that in the natural slopes. About 40% of samples in the developed spaces contained Se level higher than the drinking water guideline value proposed by the World Health Organization. Se was found to be positively correlated with B and SO4(2-) (R = 0.534 and 0.631, respectively), suggesting that Se may also be related to leakage from sewage pipes. Part of the Sr may come from leakage of flushing water and/or sewage as Sr was strongly correlated with Cl- (R = 0.929). According to the measured results, deep groundwater samples collected from piezometers (> 10 m in depth) in the urbanized spaces appeared to be virtually free from any anthropogenic contaminations. This study may shed important light on the identification and evaluation of leakage from service pipes in a particular area based on aqueous distributions of heavy metals and trace elements. Moreover, the above findings may be instructional for other coastal cities with a similar level of urban development to understand the potential threats to their groundwater resources.