Mercury is a potent neurotoxic substance and accounts for 250,000 intellectual disabilities annually. Worldwide, coastal fisheries contribute the majority of human exposure to mercury through fish consumption. Recent global mercury cycling and risk models attribute all the mercury loading to the ocean to atmospheric deposition. Nevertheless, new regional research has noted that the riverine mercury export to coastal oceans may also be significant to the oceanic burden of mercury. Here we construct an unprecedented high-spatial-resolution dataset estimating global river mercury and methylmercury exports. We find that rivers annually deliver 1,000 (minimum–maximum: 893–1,224) Mg mercury to coastal oceans, threefold greater than atmospheric deposition. Furthermore, high flow events, which are becoming more common with climate change, are responsible for a disproportionately large percentage of the export. Coastal oceans constitute 0.2% of the entire ocean volume but receive 27% of the external mercury input to the ocean. We estimate that the river mercury export could be responsible for a net annual export of 350 (interquartile range: 52–640) Mg mercury across the coastal–open-ocean boundary, although there is still high uncertainty around this estimate. Our results show that river export is the largest source of mercury to coastal oceans worldwide, and continued mercury risk modelling should incorporate the impact of rivers.