Objective Arsenic is a potent environmental pollutant that has caused one of the largest public health poisonings in the history of human civilization, affecting tens of millions of people worldwide especially in Bangladesh.Chronic arsenic exposure has been shown as a cause for organ damage.However, the association between arsenic exposure matrices (drinking water, hair and nails) and the organ specific markers e.g.lactate dehydrogenase (LDH), alkaline phosphatase (ALP), aspartate transaminase (AST), alanine transaminase (ALT), plasma cholinesterase(PChE), lipid profile (TC, LDL, HDL) activity has not yet clearly been documented.Therefore, the aim of our study was to investigate the association between arsenic exposure matrices and the organ specific markers activity in the population of arsenic-endemic areas in Bangladesh.Methods Residents living in arsenic-endemic areas in Bangladesh were selected as study subjects.Arsenic concentrations in drinking water, hair and nails were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS).The study subjects were split into quartile groups based on the concentrations of arsenic in water, hair and nails: lowest, low, medium and high.Activities of different organ specific markers i.e.LDH, ALP, AST, ALT, PChE, lipid profile were assayed by an analyzer.Results Arsenic concentrations in hair and nails were positively correlated with the arsenic levels in drinking water.Before and after adjusting for different covariates, we found that arsenic concentrations in drinking water and hair and nails were significantly associated with the activities of LDH, ALP, AST, ALT, and PChE.We also found abnormal lipid profile levels of the arsenic exposed study subjects.Conclusions The study demonstrated that arsenic concentrations in water, hair and nails were associated with different biochemical parameters of organ dysfunction.These results might be helpful for the early prognosis of organ or tissue damage in the individuals who were exposed to arsenic chronically.