A set of biomarkers was used to assess the impact of heavy metal pollution by a ferro-nickel smelting plant in Larymna bay (North Evoikos Gulf, Greece). These included a biomarker reflecting health status of an organism (scope for growth, SFG), a cellular biomarker of heavy metal exposure (composition of metal-containing granules), and two biochemical biomarkers reflecting oxidative stress (glutathione peroxidase, GPX) and neurotoxicity (acetylcholinesterase, AChE) measured in mussels (Mytilus galloprovincialis) both native and transplanted for 1 and 6 months at the coastal area of Larymna. All biomarkers in mussels at Larymna revealed differences from mussels at a reference site, signaling effects of the increased heavy metal levels on the biota. While effects on SFG and GPX in Larymna mussels were obvious on short-term exposure and persistent during chronic exposure, only chronic exposure induced a possibly cumulative effect on AChE. To validate the causal relationship between heavy metal exposure and effects observed in Larymna, SFG, GPX, and ACHE were examined in mussels exposed to a mixture of heavy metals (Ni, Cr, and Fe) under controlled laboratory conditions. The laboratory experiment verified the causal relationship between SFG and GPX responses and heavy metals but this was not demonstrated for AChE. Results from field-collected and laboratory-exposed mussels indicated a potential of GPX as predictive biomarker of population-level effects of heavy metal exposure.