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Abstract In Cameroon, dietary staples are frequently contaminated with diverse toxic fungal metabolites, known as mycotoxins. Aflatoxins and fumonisins are a public health concern, particularly concerning cancer and/or early life stunting. Mycotoxin mixtures are predicted from food measures; and this study reports the levels and frequencies of urinary mycotoxin biomarkers in Cameroonian adults. A single first void urine sample was collected from 89 adults from Yaoundé, Cameroon. Urine samples were tested for eight distinct mycotoxins using measures of both parent compounds and/or their metabolites by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Altogether, seven distinct mycotoxins, aflatoxin, fumonisin, deoxynivalenol, zearalenone, nivalenol, ochratoxin A, and citrinin, (or their metabolites) were observed in urine samples. At least one mycotoxin was detected in all of the urine samples, 87 (98%) of which were above the limit of quantitation. Aflatoxin M₁was detected in 42% (n.d.-0.21 μg/l) of samples of which about a quarter additionally contained fumonisin B₁. Of the remaining toxins deoxynivalenol (78%), zearalenone (99%), ochratoxin A (95%), nivalenol (53%), and citrinin (87%) were present in the samples. Alternariol was not detected in any sample. Mixtures of mycotoxins in the samples were frequently observed with 64 samples (72%) containing more than five mycotoxin exposure biomarkers. Estimates of intake exceeded the TDIs for fumonisin B₁(n = 4), deoxynivalenol (n = 1) and zearalenone (n = 2), no TDI is set for aflatoxin. This study reveals frequent co-exposure of Cameroonian individuals to a complex mixture of toxic and carcinogenic mycotoxins, with mixtures of aflatoxin and fumonisin being a particular priority from a public health standpoint.