Arsenic-rich geothermal fluids are hazardous materials of global impact, affecting different environments (groundwater, surface water, seawater, sediments, soils, atmosphere) and human and animal health. They can be released naturally or through human activities. For the first time, a systematic global assessment of geothermal arsenic (As) in fluids of the six principal types of geothermal reservoirs and their environmental impact (e.g. freshwater sources used for drinking and irrigation), distinguishing between different uses (if any), was performed based on research of the geochemical characteristics and geotectonic setting of the formation of natural geothermal reservoirs worldwide. This will assist to further improve the sustainability of geothermal energy use, which can be an excellent environmental friendly renewable energy resource for electric power production and direct heat use. Arsenic in geothermal fluids (up to several tens of mg/L) originates especially in deep seated (several kilometers) reservoirs. Proper management of geothermal fluids during exploration, exploitation, use and disposal of resulting waste products through sustainable As mitigation strategies are essential. However, more research about As speciation and volatile As is necessary to fulfil this aim. Therefore As (and its principal species) needs to be included as parameter for standard analysis and monitoring program in any project using geothermal fluids from exploration to management of resulting wastes as base to define appropriate mitigation actions.