The first global-scale assessment of Sb contamination in soil that was related to mining/smelting activities was conducted based on 91 articles that were published between 1989 and 2021. The geographical variation, the pollution level, the speciation, the influencing factors, and the environmental effects of Sb that were associated with mining/smelting-affected soils were analyzed. The high Sb values mainly occurred in developed (Poland, Italy, Spain, Portugal, New Zealand, Australia) and developing (China, Algeria, Slovakia) countries. Sb concentrations of polluted soil from mining areas that were reported in most countries significantly exceeded the maximum permissible limit that is recommended by WHO, except in Turkey and Macedonia. The soil Sb concentrations decreased in the order of Oceania (29,151 mg/kg) > North Africa (13,022 mg/kg) > Asia (1527 mg/kg) > Europe (858 mg/kg) > South America (37.4 mg/kg). The existing extraction methods for Sb speciation have been classified according to the extractant, however, further research is needed in the standardization of these extraction methods. Modern analytical and characterization technologies, e.g., X-ray absorption spectroscopy, are effective at characterizing chemical speciation. Conditional inference tree (CIT) analysis has shown that the clay content was the major factor that influenced the soil Sb concentration. Non-carcinogenic risks to the public from soil Sb pollution were within the acceptable levels in most regions. An Sb smelter site at the Endeavour Inlet in New Zealand, an abandoned open-pit Sb mine in Djebel Hamimat, Algeria, an old Sb-mining area in Tuscany, Italy, and Hillgrove mine in Australia were selected as the priority control areas. Cynodon dactylon, Boehmeria, Pteris vittata, and Amaranthus paniculatus were found to be potential Sb accumulators. All of the values of bioaccumulation factors for the crops were less than one. However, ingestion of Sb through crop consumption posed potential non-carcinogenic health risks, which should not be neglected. The soil variables (pH, Eh, total sulfur, carbon nitrogen ratio, total organic carbon, and sulfate), the total Sb and the bioavailable Sb, and heavy metal(loid)s (As, Pb, and Fe) were the major parameters affecting the microbial community compositions.