The study illustrates the critical role of accurate geological structural mapping to delineate crystalline aquifer zones more prone to high health risk due to elevated dissolved As in drinking wells. The analysis revisits the results from more than 1200 groundwater samples collected over ten years from domestic wells across the Tampere region (Finland). It is demonstrated that the highest dissolved As concentrations in the region (up to 2230 μg/L) are exclusively found near major faults and deformation zones (FDZs) detected via geophysical and geological surveys, and that a clear correlation exists between dissolved concentrations and the distance from the FDZs (r). Almost all values exceeding the drinking water limit (10 μg/L) occur at r < 8 km, while concentrations above 100 μg/L occur at r < 4 km. Solid-phase As concentrations in bedrock show less dependency on FDZ than aqueous concentrations. This behavior is explained considering different mechanisms, which include enhanced sulfide oxidation and fracture connectivity, promoting preferential transport of dissolved As to FDZs and mixing of waters from different redox zones, mobilizing preferentially As(III) or As(V). Fe hydro-oxides may also precipitate/dissolve preferentially because of FDZs, while residence time may influence the contact time between water and As-bearing minerals. It is concluded that the accurate mapping of FDZs, and in general of structural geology, provides an important preliminary information to identify where localized, site-specific characterization of hydrogeology and geochemistry is more urgent to reduce As-related health risk from groundwater intake.