Arsenic is highly toxic and widely occurred in the Mekong delta of Viet Nam. The delta is also known as one of the three deltas in the world that is likely to suffer extreme weather conditions such as flooding, drought, sea level rise, saline intrusion resulting from the variations of climatic conditions. Under changing climate, environmental conditions have been changed. As a result, agricultural practices have also been modified to adapt with changing new circumstances. The shifting in environmental conditions and adaptation practices could result in enhancing mobilization of arsenic in environments thus increasing exposure pathways of arsenic to human health. This paper will discuss the source of arsenic in the Mekong Delta, arsenic mobilization, and potential impact of climate change and adaption strategies on arsenic mobilization within rice production systems. Future research will be recommended to address the knowledge gaps when considering adaptation strategies and the impacts of climate changes in the Mekong delta context.