In the presence of different environmental stressors, diatoms can produce frustules presenting different types of deformities. Metals and trace elements are among the most common causes of these teratological forms. Metal enrichment in water bodies can be attributed to the geological setting of the area or to pollution. The widespread benthic diatom Achnanthidium minutissimum (ADMI) is one of the most metal-tolerant species. In the present study, ADMI teratologies were defined from samples taken from eight very diverse, widely-distributed inland-water habitats: streams affected by active and abandoned mining areas, a metal-contaminated stream, a spring in an old chalcopyrite mine, a mineral-water fountain, and a sediment core taken from a lake affected by metal contamination in the past. Deformed frustules of ADMI were characterised mainly by one (sometimes two) more or less bent off ending, conferring to the specimens a cymbelloid outline (cymbelliclinum-like teratology, CLT). Marked teratologies were distinguished from slight deformities. Hydrochemical analyses, including metals and trace elements, were carried out and enrichment factors (EF) relative to average crustal composition were calculated. To improve our knowledge on the potential of different metals and trace elements to trigger the occurrence of ADMI CLT, we carefully selected 15 springs out of 110 (CRENODAT dataset) where both ADMI and above-average metal or metalloid concentrations occurred, and re-analysed these samples. The results from the eight widely-distributed core sites as well as from the 15 selected CRENODAT springs led to the hypothesis that two metals (copper and zinc) and a metalloid (antimony) were the most likely triggers of ADMI CLT formation. From a quantitative point of view, it is worth noting that the lowest concentrations triggering ADMI CLT can be fairly low, particularly in the case of copper contamination. The antimony-rich site was characterised by a marked-teratology variant where both ends of ADMI were bent off.