The concentration and spatial distribution of naturally occurring radionuclides 238U, 232Th and 40K in the river sediments in Ilobi and Erinja communities were assayed using well calibrated (HPGe detector) ?–spectrometry in order to assess the potential radiological health hazards and lifetime cancer risks associated with the use of the river sediments. The radio-analytically calculated ranges of activity concentrations of 238U, 232Th and 40K were 0.0?166.8±19.5Bqkg-1, 0.0?17.9±6.7Bqkg-1 and 181±3.3?814±29.4Bqkg-1 respectively. The mean activity concentrations of 238U and 40K exceeded the typical admissible world average values. To assess the complete radiological hazards of the river sediments, ten radiological and health hazard indices were calculated. The results indicated that the average value of each radiological hazard parameter were below the world average value reported in UNSCEAR except annual gonadal dose equivalent and internal hazard index whose mean value exceeded their recommended limits. It follows therefore that there is a fingering potential radiological hazard directly associated with the sediments from those locations. Sediments from a specific location in both communities have the ELCR values higher than the world average value, which is suggestive of its likelihood of inducing cancers over a period of exposure to humans. The statistical treatment result shows that the distribution of the radionuclides (238U & 232Th) was asymmetrical and peaked with an observed flat distribution in 40K level in the sediments. Extensive research needs to be carried out on Okooko River in Ilobi community as its sediment shows consistent higher concentration in both radionuclides and radiological hazard indices.