Selenium is an essential trace element for humans and other animals, and there is mounting evidence for the efficacy of certain forms of selenium as cancer-chemopreventive compounds. However, over the years, numerous elements such as As, Cu, Zn, Cd, Hg, Sn, Pb, Ni, Co, Sb, Bi, Ag, Au, and Mo have been found to inhibit anti-carcinogenic effects of selenium, which may affect the anti-carcinogenic activity of selenium. The interaction between selenium and arsenic has been one of the most extensively studied. The proposed mechanisms of this interaction include the increase of biliary excretion and direct interaction/precipitation of selenium and arsenic, and their effects on zinc finger protein function, cellular signaling and methylation pathways. This article focuses on these proposed mechanisms and how anti-carcinogenic effects of selenium may be affected by arsenic.