Heavy metal-bearing sediment particles enter river systems by discharge of mine or processing waste, tailings dam failures, remobilization of mining-contaminated alluvium and mine drainage. The mineralogy and geochemistry of these particles is dependent upon the original ore mineralogy, and on processes that have occurred in the source areas, during transport and deposition and during postdepositional early diagenesis. This paper reviews the research carried out to date on the sources, mineralogy, chemistry and fate of heavy metal-bearing particles in mining-affected river systems, and identifies six important avenues for further investigation.