Abstract: Mercury (Hg), a major contaminant in soil heavy metal pollution, poses serious health risks to humans. Current soil quality standards primarily regulate pollution based on the total concentration of pollutants in the soil, without fully accounting for the actual amount absorbed during human exposure, which may lead to an overestimation of health risks. This article summarizes the current situation of soil Hg pollution, its migration and transformation mechanisms, and its toxic effects on human health, along with their underlying mechanisms. It also reviews the advantages, disadvantages, and applications of in vivo and in vitro models used for Hg health risk assessment, and finally proposes the selection of soil Hg pollution remediation methods based on refined human health risk assessments. The results show that the spatial variation of soil Hg content in China is large, and the soil Hg content in provinces, municipalities, and autonomous regions is closely related to Hg emissions from industrial and mining atmospheres. Regions with high average soil Hg content are distributed in coastal areas with Hg-related industrial activity. After migration and transformation, soil Hg comes into contact with the population, enters the human bloodstream and brain, and poses health risks. Hg exposure has a significant negative impact on health. Cells are prone to death under Hg exposure due to the production of reactive oxygen species, inhibition of antioxidant stress proteins, and increased oxidative stress. At low concentrations, organic Hg induces apoptosis in differentiated human neurons, whereas high concentrations cause cell necrosis, severely impacting the nervous system. Hg exposure during the embryonic and childhood periods leads to nerve damage in later stages of life. Hg exposure disrupts mitochondrial function in kidneys, affecting their metabolism. Many studies on Hg toxicity use in vivo mouse models alongside in vitro cell models of the intestine, nervous system, and kidneys to investigate the potential toxic effects of Hg. Brain nerve and liver cancer organoid models have been applied to study the neurotoxicity and liver cancer toxicity mechanisms of heavy metals. Existing remediation methods for soil Hg pollution include soil replacement, thermal desorption, microbial remediation, phytoremediation, soil fixation and stabilization remediation, soil leaching, and nanomaterial-based remediation technologies. However, the current evaluation system tends to overestimate health risks. Based on the results of the human health risk assessment of soil Hg pollution, selecting targeted remediation methods for specific regions will effectively reduce remediation costs and improve remediation efficiency. To make the assessment results more realistic and accurate, future studies can utilize organoid models to investigate the corresponding toxicity of soil Hg pollution. Additionally, a differentiated assessment model can be established by comprehensively considering different exposure pathways and individual differences for precise human health risk assessment. Based on the refined assessment results, multifaceted control and remediation of soil Hg pollution can be carried out to effectively reduce the health risks of soil Hg pollution.