Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure 20 trace elements in PM2.5 from the Tangshan heavy industry areas. The variation characteristics, potential sources, and health risks of these trace elements were analyzed in great detail within the research area. The results showed that the annual total concentration of the 20 elements in the research area did not change significantly from 2016 to 2017, and the contributions of Na, Mg, Al, K, Ca, and Fe were very high, accounting for 89–96% of the total concentration. The concentrations of these elements were higher during the day than they were at night, and the concentrations in the spring and winter were higher than they were in the summer and autumn. Five potential sources were identified using the positive matrix factorization (PMF) model and enrichment factors (EFs). Traffic, dust source, oil combustion, coal combustion, and industrial sources contributed 17.80%, 12.2%, 8.8%, 7.7%, and 53.5% to the total trace elements, respectively. The contribution of each source was significantly different during different seasons. Industrial sources including steel industry and cement production were the largest source; nearly 70% of the total trace elements in the winter of 2017 were from industrial sources. The health risk assessment reflected that the cancer risks of Cr, Ni, and Cd to adults, and Cr to children were higher than the acceptable levels (1 × 10−6). Furthermore, Mn had a potential non-carcinogenic risk to children and adults, which should be given more attention by relevant departments.