Environmental exposure to arsenic (As) in the Kutahya region of the western Anatolia, Turkey has been reported to cause various types of arsenic-associated skin disorders (Dogan, Dogan, Celebi, & Baris, 2005). A geological and mineralogical study was conducted to find the sources and distribution of the As. Geogenic (background) levels were measured in samples collected from various sources in the Gediz, Simav, Tavsanli, Emet, Yoncali, Yenicekoy, and Muratdagi areas of the Kutahya region. Based on this analysis, we determined that natural sources are a domineering factor affecting the distribution of As, which was found: (1) mainly in evaporitic minerals, including colemanite (269-3900 ppm) and gypsum (11-99,999 ppm), but also in alunite (7-10 ppm) and chert (54-219 ppm); (2) in secondary epithermal gypsum, which has a high concentration of As in the form of realgar and orpiment along fracture zones of Mesozoic and Cenozoic carbonate aquifers; (3) in rocks, including limestone/dolomite (3-699 ppm) and travertine (5-4736 ppm), which are relatively more enriched in As than volcanics (2-14 ppm), probably because of secondary enrichment through hydrological systems; (4) in coal (1.9-46.5 ppm) in the sedimentary successions of the Tertiary basins; (5) in thermal waters, where As is unevenly distributed at concentrations varying from 0.0-0.9 mg/l. The highest As concentrations in thermal water (Gediz and Simav) correlate to the higher pH (7-9.3) and T (60-83 degrees C) conditions and to the type of water (Na-HCO3-SO4 with high concentration of Ca, Mg, K, SiO2, and Cl in the water). Changes in pH can be related to some redox reactions, such as the cation exchange reactions driving the dissolution of carbonates and silicates. Fe-oxidation, high pH values (7-9.3), presence of other trace metals (Ni, Co, Pb, Zn, Al), increased salinity (Na, Cl), high B, Li, F, and SiO, high Fe, SO4 (magnetite, specularite-hematite, gypsum), and graphite, and the presence of U, Fe, Cu, Pb, Zn, and B, especially in the Emet, Gediz, and Simav areas, are the typical indicators for the geothermally affected water with high As content. A sixth source of As in this region is the ground (0.0-10.7 mg/l) and the surface waters (0.0022-0.01 mg/l), which are controlled by water-rock interaction, fracture system, and mixing/dilution of thermal waters. The high As concentration in groundwater corresponds to the areas where pathological changes are greatest in the habitants. Arsenic in ground water also effects ecology. For example, only Juriperus oxycedrus and J. varioxycedrus types of vegetation are observed in locations with the highest concentration of As in the region. Branches and roots of these plants are enriched in As.