In low-income, rural, and indigenous communities, metal mining is associated with numerous negative social, political, economic, human, and environmental health impacts. A number of studies from around the world have looked at specific aspects of human and environmental health related to various contaminants from mining and the landscape alterations associated with the processes, along with the growing community resistance and opposition to mining operations. The individual impacts of each of these components are understood, but a deeper understanding of the syndemic effects of a mine operating in a community, particularly in an indigenous community, was needed, especially as the industry is expected to grow around the world. Using a community-based participatory research (CBPR) approach, we utilized a combination of participatory mapping, interviews, and community mapping workshops to examine the underlying patterns and perceptions of environmental risk and healthy and unhealthy spaces in the Ch'orti' communities of Olopa, Guatemala that have been impacted by the Cantera Los Manantiales antimony mine. Results suggest that, since mining operations began, residents have experienced an increase in violence and community divisions surrounding the mine, a higher incidence of a variety of diseases, and an extensive loss of crops and domesticated animals. Furthermore, participants were concerned about both water and air contamination, all of which they attributed to the mine. The results of the study will be useful for local activist leaders and allied NGOs to effectively assess and improve health in indigenous communities impacted by the Cantera Los Manantiales mine in Olopa. The approach, particularly the use of participatory mapping methods, could be implemented in future studies attempting to understand syndemics and other environmental health risks and outcomes.