This study assessed the accumulation of metals in a horizontal subsurface flow constructed wetland treating domestic wastewater of 350 PE after three years of operation. Metal concentrations in the influent wastewater, effluent, sediment, leaves, stems, and belowground biomass of Phragmites australis were analysed. Spatial variations were assessed by sampling at increasing distance from the inlet and at different positions across the width of the reed bed. All metals except Fe and Mn were efficiently removed in the CW, total metal concentrations in the effluent complied with basic environmental quality standards for surface water, and dissolved metal concentrations were often lower than analytical detection limits. Removal efficiencies varied between 49% for Ni and 93% for Al. Export of dissolved Mn and particulate Fe occurred, probably related to redox conditions in the sediment. After 3 years of operation, the sediment in the inlet area was significantly contaminated with Zn, Cu, and Cd, whereas Pb could form a contamination problem within the near future. The Cr and Ni levels in the sediment were low throughout the entire reed bed. At this stage of operation, the contamination problem was still situated within the inlet area and metal concentrations in the sediment decreased towards background values further along the treatment path. An exponential decrease of the metal mass in the sediment and belowground biomass was seen for all metals except Mn. Contrary to the other metals, Mn concentrations in the sediment increased with distance. For all metals, less than 2% of the mass removed from the wastewater after passage through the reed bed is accumulated in the aboveground reed biomass. The sediment acts as the primary sink for metals.