Arsenic produces a variety of stress responses in mammalian cells, including metabolic abnormalities accompanied by growth inhibition and eventually apoptosis. Morphological alterations in cells exposed to arsenic often suggest underlying disruption of cytoskeletal structural elements responsible for cellular integrity, shape, and locomotion. However, specifics of the ultrastructural changes produced by arsenic remain poorly understood. Various tissues and organs differ in their sensitivity to arsenic, with the liver and skin being the most studied. Characteristic skin pathology related to arsenic exposure ranges from hyperkeratotic lesions to squamous-cell carcinomas. However, molecular events in the arsenic-exposed skin still remain to be elucidated. Although mutagenicity of arsenic has not been unequivocally established, recent evidence supports the view that oncogenic mutations do occur, and that only selected enzymes related to DNA replication and repair are affected by arsenic. Sensitivity of the mitotic spindle to arsenic, particularly its organic compounds, underlies the well-documented chromosomal aberrations in arsenic-exposed populations. Arsenite-induced stress at the molecular level shares many features with the heat shock response. This includes the differential sensitivity of the stress signal pathway elements to the magnitude of the stress, stressor-specific activation of the response elements, and the protective role of the heat shock response. Oxidative stress, the central component of heat shock response, is typical of arsenic-related effects that are, in fact, regarded as the chemical paradigm of heat stress. Similar to heat stress, arsenite induces heat shock proteins (HSPs) of various sizes. The signal cascade triggered by arsenitelike heat stress induces the activity of the mitogen-activated protein (MAP) kinases, extracellular regulated kinase (ERK), c-jun terminal kinase (JNK) , and p38. Through the JNK and p38 pathways, arsenite activates the immediate early genes c-fos, c-jun, and egr-1, usually activated by various growth factors, cytokines, differentiation signals, and DNA-damaging agents. Like other oxygen radical-producing stressors, arsenic induces nitric oxide production at the level of transcriptional activation along with induction of poly(ADP)ribosylation, NAD depletion, DNA strand breaks, and formation of micronuclei. This review presents an overview of current research on molecular aspects of arsenic stress with an emphasis on the tissue-specific events in humans. It deals with current progress on the understanding of the signal transduction pathways and mechanisms underlying the sensitivity of various species, organs, and tissues to arsenic.