Essential Tremor (ET) is one the most common movement disorders affecting 1% of the population. Both genetic and environmental factors may trigger the pathophysiology that eventually cause ET. Blood Pb levels in ET patients has been studied. However, there is no clear data in the literature evaluating the blood levels of other heavy metals (Aluminum, Chromium, Manganese, Nickel, Copper, Zinc, Cadmium, Antimony, Tin) in ET patients. We aimed to investigate the relationship between blood heavy metal levels and tremor characteristics of ET patients. A total of 110 ET patients and 146 healthy controls were included. The control group was divided into Control-1(52 patients' household members) and Control-2(94 unrelated healthy individuals). All patients underwent a detailed neurological examination and Basic Tremor Evaluation Scale, Fahn-Tolosa-Marin Tremor Scales were recorded for the patient group. Peripheral blood samples were collected from all participants and heavy metal levels were examined and analyzed. Patient average of age 52.10±17.00; control group was 46.00±15.85 Al, Cd, Cr and Sb blood levels were statistically significantly higher in ET patients compared to the control group (for Al; χ 2 =8.684; p=0.013, for Cd; F=7.883, p<0.001, for Cr; χ 2 =8.175; p=0.017, for Sb; χ 2 =9.075; p=0.011). The duration of the disease was found to be positively correlated with Al blood levels (r=0.227, p=0.017). Our results revealed that ET is associated with elevated blood levels of Al, Cd, Cr and Sb. Investigating the etiological role of heavy metals will enable the establishment of novel therapeutic approaches to prevent or cure ET.