In Bangladesh and the neighboring state of West Bengal, India, over 100 million people are affected by widespread arsenic poisoning through drinking water drawn from underground sources containing arsenic at concentrations well above the permissible limit of 50 μg/L. The health effects caused by arsenic poisoning in this area is as catastrophic as any other natural calamity that occurred throughout the world in recent times. Since 1997, over 200 community level arsenic removal units have been installed in Indian subcontinent through collaboration between Bengal Engineering and Science University (BESU), India and Lehigh University, USA. Approximately 200,000 villagers collect arsenic-safe potable water from these units on a daily basis. The treated water is also safe for drinking with regard to its total dissolved solids, hardness, iron and manganese content. The units use regenerable arsenic-selective adsorbents. Regular maintenance and upkeep of the units is administered by the villagers through formation of villagers' water committee. The villagers contribute towards the cost of operation through collection of a small water tariff. Upon exhaustion, the adsorbents are regenerated in a central facility by a few trained villagers. The process of regeneration reduces the volume of disposable arsenic-laden solids by nearly two orders of magnitude and allows for the reuse of the adsorbent material. Finally, the arsenic-laden solids are contained on well-aerated coarse sand filters with minimum arsenic leaching. This disposal technique is scientifically more appropriate than dumping arsenic-loaded adsorbents in the reducing environment of landfills as currently practiced in developed countries including the United States. The design of the units underwent several modifications over last ten years to enhance the efficiency in terms of arsenic removal, ease of maintenance and ecologically safe containment and disposal of treatment residuals. The continued safe operation of these units has amply demonstrated that use of regenerable arsenic-selective adsorbents is quite viable in remote locations. The technology and associated socio-economic management of the units have matured over the years, generating promise for rapid replication in other severely arsenic-affected countries in Southeast Asia.