Resource-use patterns may entail systemic risks and cascade effects, which consequently inhibit the ability to deliver socioeconomic services. Identifying resource-use patterns exhibiting systemic risks and reshaping their combinations is a potential lever in realizing the transition to a sustainable, resilient, and resource-secure system. Using an island context to assess the quantity and composition of resource throughput enables a more comprehensive analysis of these risks. This article presents the first mass-balance account of socio-metabolic flows for The Bahamas in 2018, to identify socio-metabolic risks and cascading effects. Socio-metabolic risks are systemic risks related to critical resource availability, material circulation integrity, and (in)equities in cost and benefit distributions. We utilize the economy-wide material flow accounting framework to map the material flow patterns across the economy. In 2018, annual direct material input was estimated at 9.4 t/cap/yr, of which 60% were imports. High masses of waste (1.4 t/cap/yr) remained unrecovered due to the lack of recycling. Total domestic extraction (DE) were dominated by non-metallic minerals with more than 80%, while marine biomass makes up barely 1% of total DE. Due to its linear, undiversified metabolism, and heavy imports dependency, the system is susceptible to socio-metabolic risks and cascading effects including low levels of self-sufficiency, high vulnerability to shocks, commodity price fluctuations, threats to sensitive ecosystems, health impacts, and economic losses, among others. A holistic resource management strategy and nature-based solutions that consider the trade-offs and synergies between different resource-use patterns are critical when exploring potential plans for metabolic risk reduction.