Naturally occurring As found in groundwaters has been identified to be a problem in at least 10 provinces of Cambodia with Kandal being one of the most heavily impacted. Estimates, using groundwater quality and population data for Kandal Province of Cambodia, suggest that over 100,000 people are at high risk of chronic As exposure. Levels in some areas approach 3500 lg/L, against the Cambodian Standard of 50 lg/L. Considerable work remains to adequately characterize the extent of As hazard and its possible health effects in Cambodia and the region. It is likely that additional populations will develop health problems attributed to As, of particular concern is arsenicosis. The symptoms of arsenicosis have been generally assumed to develop after 8–10 years of consumption of water with elevated As levels, however, new cases discovered in Cambodia have been identified with exposure times as short as 3 years. The rapid onset of arsenicosis may be attributed to contributing risk factors related to socioeconomic status, including malnutrition. It is thus imperative to develop strategies to rapidly identify possible regions of enrichment, to minimize exposure to As-rich waters, and to educate affected populations. To date the response to the As hazard has been led by the Ministry of Rural Development in cooperation with international organizations and NGOs, to identify at risk areas, and educate communities of the risk of As-rich water. However better coordination between government bodies, NGOs and donor agencies active in the field of water supply and treatment is essential to minimize future As exposure.