<p>Geogenic contamination of groundwater aquifers with arsenic (As) has been a matter of concern worldwide; however, accelerated anthropogenic actions threaten natural ecosystems and human health. Groundwater As contamination poses significant health risks in both India and worldwide. This comprehensive review examines the sources, distribution, and health implications of As pollution in India, taking into account its global significance. This review summarizes an analysis of geochemical processes, contamination factors, climate change, health risks, affected regions, detection and remediation technologies, and policy frameworks. The findings indicate that the groundwater in the Indo-Gangetic plains and several states is highly contaminated with As due to both geogenic sources and anthropogenic activities, resulting in chronic exposure that leads to skin lesions and various forms of cancer. This review further assesses conventional and emerging advanced detection methods (e.g., field test kits, spectroscopic techniques, etc.,) and remediation technologies (adsorption, membrane filtration, and bioremediation), highlighting their efficacy, scalability, and limitations in resource-constrained settings. Despite existing policy frameworks, gaps in enforcement, funding, and infrastructure persist, undermining mitigation efforts. Therefore, this review advocates for an integrated approach that combines advanced remediation, strengthened monitoring systems, and community-engaged water governance. Prioritizing As-free drinking water as a fundamental public health service is critical to safeguarding human health and ecosystems. Lastly, this review concludes and underscores the urgency of evidence-based interventions and identifies key research directions to inform sustainable solutions.</p>