Providing potable water to populations world-wide is an important agenda in the public health arena. In this regard, many nations have embraced well drilling resulting in a significant reduction in waterborn diarrhoeal diseases. Unfortunately, much of the earth's crust is saturated with arsenic which filters into the waters and may have health implications when used for drinking. The delayed health effects of exposure to arsenic and lack of local awareness of possible effects of arsenic make it mandatory for all wells and any source of underground water to be tested for the element. The literature shows that no one continent is spared from arsenic contaminations and poisoning. The disease burden and the consequent health care cost on individuals, families, communities and nations remain a debate and a policy issue. The review describes the public health problem of arsenic exposure with aspects on the source of exposure, risks of exposure, the problem with arsenic from drinking water, dietary exposure of arsenic, and challenges to surveillance.