Arsenic (As) distribution and toxicology in the environment is a serious issue, with millions of individuals worldwide being affected by As toxicosis. Sources of As contamination are both natural and anthropogenic and the scale of contamination ranges from local to regional. There are many areas of research that are being actively pursued to address the As contamination problem. These include new methods of screening for As in the field, determining the epidemiology of As in humans, and identifying the risk of As uptake in agriculture. Remediation of As-affected water supplies is important and research includes assessing natural remediation potential as well as phytoremediation. Another area of active research is on the microbially mediated biogeochemical interactions of As in the environment. In 2005, a conference was convened to bring together scientists involved in many of the different areas of As research. In this paper, we present a synthesis of the As issues in the light of long-standing research and with regards to the new findings presented at this conference. This contribution provides a backdrop to the issues raised at the conference together with an overview of contemporary and historical issues of As contamination and health impacts.