Arsenic can either enhance or reduce nitric oxide (NO) production, depending on the type of cell, the species and dose of arsenical tested. The mechanisms of how arsenic increases or decreases NO production remain unclear. Because NO is associated with many pathological conditions, it is conceivable that in those arsenic-target tissues, the NO production may be upregulated by continuous arsenic exposure, and a prolonged over-production of NO may cause inflammation hence a pathological condition. A prolonged interference with the normal physiological level of NO may also play a role in the initiation, promotion, and progression of arsenic-related human cancers. Suppression of NO production has been shown to reduce arsenite-induced oxidative DNA damage, inhibition of pyrimidine dimer excision, and micronuclei. However, a completely reliable story on how NO is involved in arsenic-related human disease is still lacking.