Elevated arsenic concentrations in drinking water occur in many places around the world. Arsenic is deleterious to humans, and consequently, As water treatment techniques are sought. To optimize arsenic removal, sorption and desorption processes were studied at a drinking water treatment plant with aeration and sand filtration of ferrous iron rich groundwater at Elmevej Water Works, Fensmark, Denmark. Filter sand and pore water were sampled along depth profiles in the filters. The sand was coated with a 100-300 microm thick layer of porous Si-Ca-As-contaning iron oxide (As/Fe = 0.17) with locally some manganese oxide. The iron oxide was identified as a Si-stabilized abiotically formed two-line ferrihydrite with a magnetic hyperfine field of 45.8 T at 5 K. The raw water has an As concentration of 25 microg/L, predominantly as As(II). As the water passes through the filters, As(III) is oxidized to As(V) and the total concentrations drop asymptotically to a approximately 15 microg/L equilibrium concentration. Mn is released to the pore water, indicating the existence of reactive manganese oxides within the oxide coating, which probably play a role for the rapid As(III) oxidation. The As removal in the sand filters appears controlled by sorption equilibrium onto the ferrihydrite. By addition of ferrous chloride (3.65 mg of Fe(II)/L) to the water stream between two serially connected filters, a 3 microg/L As concentration is created in the water that infiltrates into the second sand filter. However, as water flow is reestablished through the second filter, As desorbs from the ferrihydrite and increases until the 15 microg/L equilibrium concentration. Sequential chemical extractions and geometrical estimates of the fraction of surface-associated As suggest that up to 40% of the total As can be remobilized in response to changes in the water chemistry in the sand filter.