Potentially toxic metals (PTMs), associated with different size particles in soil, may play an important role in adverse health effect and risk for human. The objective is to evaluate the lung and gastrointestinal bioaccessibility and risk of PTMs in Pb-contaminated alkaline urban soil depending on the particle size fractions. The size fractions of 50-250 μm, 5-50 μm, 1-5 μm, <1 μm in Pb-contaminated alkaline urban soil from Baoji Heavy Industrial Base City, NW China, were screened by Sequential Wet Sieving Separation Procedure (SWSSP) based on Stokes' Law. The concentrations of 9 potentially toxic metals (As, Ba, Co, Cr, Cu, Mn, Ni, Pb and Zn) in each particle size fractions were characterized by ICP-OES and ICP-MS, and the in vitro bioaccessibility dependent of size fractions were evaluated by the simulation fluids of Artificial Lysosomal Fluid (ALF) and Gamble for lung, PBET, SBET, IVG, SBRC, UBM for gastric and intestinal, respectively. Health risks were assessed considering simulated external exposure using intestinal and lung bioaccessibility. The lung and gastrointestinal bioaccessibility and exposure risks of PTMs in fine particle size (i.e. <1 μm) was higher than larger particle size fractions (i.e. 50-250 μm, 5-50 μm, 1-5 μm), however, some different variations of bioaccessibility observed the simulation fluids and time dependent. In case of single PTMs, the lung bioaccessibilities of PTMs in ALF were higher than those in Gamble fluids, most prominent in Co, Cu, Mn and Zn, while the gastrointestinal [G + I] bioaccessibility of PTMs was less than those in gastric [G], like Cu, Mn, Pb and Zn mostly. The non-carcinogenic risks of these PTMs to children via inhalation were acceptable and higher than those of adults, but reverse for carcinogenic risk. Comparatively, the non-carcinogenic and carcinogenic risks of PTMs via ingestion pathway were both higher than those for adults. Although the risks from ingestion were in acceptable range, the total carcinogenic risks for children were more than 10, which would bring carcinogenic risks and should be paid attention to. It was noted that the toxic metal, Co in all size fractions was the most important contributor for noncarcinogenic risks and Cr mostly for carcinogenic risks via inhalation pathway for adults and children in local areas. However, Pb was the most important contributor for noncarcinogenic risk both for adults and children via ingestion pathway relative to Co and Cr for carcinogenic risks through hand-to-mouth ingestion. Those observations demonstrated the important role that the smaller particle fractionations in Pb-contaminated alkaline soil played in both bioaccessibility and the refinement of human health-risk assessments for the inhalation and ingestion pathway.