Approximately 5.4 million cubic yards of coal fly ash and water spilled into the Emory River embayment of Watts Bar Reservoir in east Tennessee on Dec 22, 2008. Raccoons were collected in 2009 and 2010 from the spill site (10/y) and unexposed areas (5/y) to determine whether metals and metalloids were accumulating in raccoons and if any negative health effects resulted from exposure to the spilled coal fly ash. Tissues were analyzed from each animal to determine the concentrations of 26 metals/metalloids. Complete blood cell counts (CBC), plasma biochemistry panels, and histopathology of select tissues also were performed. Results were analyzed by year and exposure status. Although significant differences were present in some tissues for some metals/metalloids, only arsenic in hair, iron in muscle, nickel in hair, selenium in hair and muscle, strontium in hair, and vanadium in hair and liver were increased in spill site animals (one or both years) compared with unexposed animals. No clinically important differences were observed between groups regarding CBC or plasma biochemistry analyses. Lesions were observed on histopathology in some tissues, but there was no difference in the prevalence of lesions between spill site and unexposed animals. There does not seem to be any important accumulation of metals/metalloids or negative health effects in raccoons associated with exposure to coal fly ash compared with unexposed animals.