This work provides a new perspective on small-scale treatment systems to remove arsenic from groundwater for potable applications in low-income communities. Data corroborated from the literature highlight a significant challenge to providing potable water in a financially sustainable manner in arsenic affected areas. Analysis of the literature also reveals notable deficiency in the current practice, especially the overfocus on household-scale treatment systems for arsenic affected groundwater without adequate maintenance, monitoring, and a systematic cost–benefit analysis. Accurate and reliable analysis of arsenic in water samples at relevant health guideline values is costly and technologically demanding for low-income communities. Significant discrepancy in the performance of household-scale treatment systems can be attributed to the lack of maintenance and systematic monitoring. Moreover, data on the maintenance and compliance monitoring cost of small-scale arsenic treatment systems are very limited in the literature, and the available data show an exponential increase in maintenance cost per treatment capacity unit as the treatment size decreases. On the other hand, significant opportunities exist to increase performance reliability and reduce water treatment cost by taking advantage of the current digital transformation of the water sector. The analysis in this work suggests the need to reframe current practice towards commune-scale treatment systems as an interim step before centralised water supply is available. • Arsenic contaminated groundwater significantly impacts low-income communities. • Co-contaminants must also be removed to meet drinking water standard. • Inadequate maintenance and monitoring of household-scale systems exists. • Beyond the minimum scale, performance is unreliable or unassessable. • Digitally enabled systems play an interim step before centralised water supply.