Abstract: The health risk calculated based on site-specific bioaccessible fraction of heavy metals (HMs) is more realistic than the one based on the total concentration of HMs in soil. Bioaccessibility can be measured by simulating the digestive processes of HMs desorption in human gastrointestinal system. The test methods used currently were introduced with details during the simulation process and values of key parameters of the four wildly applied methods (PBET, SBET, RIVM and UBM). The problems were analyzed in the values of parameters (e.g., pH, extraction time, components of simulated gastrointestinal solution) and the simulated processes and environments (e.g., digestive process, environment, impact of food and microorganism in the digestive tract). Further, the acceptance of risk assessment incorporating HMs bioaccessibility to the environmental administrative staff and the public in the USA and EU were also discussed. Finally, based on the review of the research development in China, four research areas were suggested:(1) standardizing of bioaccessibility test of HMs in soil based on the digestive characteristic of Chinese people; (2) finding out the key influence factors that control HMs bioaccessibility in soil and development of an empirical model to predict HMs bioaccessibility based on them; (3) verifying the bioaccessibility test methods by in vivo test and developing a bioavailability test method by combining Caco-2transportation model to the current in vitro methods; (4) developing a tiered risk assessment framework to incorporate HMs bioaccessibility and refine the guidelines currently in use.