Arsenic trioxide (As 2 O 3 ) is an effective therapeutic against acute promyelocytic leukemia and certain solid tumors. Because As 2 O 3 inhibits mitochondrial respiration in leukemia cells, we hypothesized that As 2 O 3 might enhance the radiosensitivity of solid tumors by increasing tumor oxygenation [partial pressure of oxygen (pO 2 )] via a decrease in oxygen consumption. Two murine models of radioresistant hypoxic cancer were used to study the effects of As 2 O 3 . We measured pO 2 and the oxygen consumption rate in vivo by electron paramagnetic resonance oximetry and 19 fluorine-MRI relaxometry. Tumor perfusion was assessed by Patent blue staining. In both models, As 2 O 3 inhibited mitochondrial respiration, leading to a rapid increase in pO 2 . The decrease in oxygen consumption could be explained by an observed decrease in glutathione in As 2 O 3 -treated cells, as this could increase intracellular reactive oxygen species that can disrupt mitochondrial membrane potential. When tumors were irradiated during periods of As 2 O 3 -induced augmented oxygenation, radiosensitivity increased by 2.2-fold compared with control mice. Notably, this effect was abolished when temporarily clamped tumors were irradiated. Together, our findings show that As 2 O 3 acutely increases oxygen consumption and radiosensitizes tumors, providing a new rationale for clinical investigations of As 2 O 3 in irradiation protocols to treat solid tumors. Cancer Res; 72(2); 482-90. Ó2011 AACR.