Historic tailings dams and their associated mine waste can pose a significant risk to human and environmental health. The Wheal Maid mine site, Cornwall, UK, serves as an example of the temporal evolution of a tailings storage facility after mining has ceased and the acid-generating waste subjected to surficial processes. This paper discusses its designation as a contaminated land site and reviews our current understanding of the geochemistry, mineralogy, and microbiology of the Wheal Maid tailings, from both peer-reviewed journal articles and unpublished literature. We also present new data on waste characterisation and detailed mineral chemistry and data from laboratory oxidation experiments. Particularly of interest at Wheal Maid is the presence of pyrite-bearing “Grey Tailings”, which, under typical environmental conditions at the Earth’s surface, would be expected to have undergone oxidation and subsequently formed acidic and metalliferous mine drainage (AMD). The results identified a number of mechanisms that could explain the lack of pyrite oxidation in the Grey Tailings, including a lack of nutrients inhibiting microbial Fe(II) oxidation, passivation of pyrite mineral surfaces with tailings processing chemicals, and an abundance of euhedral pyrite grains. Such research areas need further scrutiny in order to inform the design of future tailings facilities and associated AMD management protocols.