Background: The ingestion of golden thread contaminated with heavy metals through the food chain leads to detrimental effects to human health. During digestion, not all of the heavy metals could be released to the gastrointestinal tract and readily to be absorbed by human body. Thus, bioaccessibility is an important issue in health risk assessments. Aims and Objectives: The aims and objectives of this study were to investigate the bioaccessibility of Cd in golden thread and assess the associated health risks based on the exposure to bioaccessible Cd. Materials and Methods: Inductively coupled plasma mass spectrometry (ICP-MS) has been applied to determine the Cd content in golden thread. Physiologically based extraction test (PBET) digestion was performed in the in vitro/Caco2 cell model to investigate the bioaccessibility of Cd in golden thread. Furthermore, the target hazard quotient (THQ) was used to assess the risks of the total and the bioaccessible content of Cd in golden thread. Results: The results revealed that the total Cd content in six batches of golden thread ranged from 3.203 to 5.723 mg/kg. After uptake by Caco2 cells, the bioaccessibility of Cd ranged from 42.36％ to 59.73 ％. The results of the risk assessment indicated that prior to uptake by Caco2 cells, the THQ values of Cd for all batches of golden thread were greater than 1. However, after uptake by Caco2 cells, the THQ values of Cd in all samples were less than 1, thus suggesting that the risks were at a safe level. Conclusion: This study was the first to perform health risk assessment with bioaccessible heavy metals present in traditional Chinese medicine by PBET digestion using an in vitro/Caco2 cell model, thus enabling us to obtain more accurate and objective results while allowing us to avoid unnecessary government intervention and to establish more reasonable limit standards for heavy metals.