This study investigated the feasibility of using an alkaline pressure oxidative leaching process to treat lead smelter flue dust containing extremely high levels of arsenic with the aim of achieving the selective separation of arsenic. The effects of different parameters including NaOH concentration, oxygen partial pressure, liquid-to-solid ratio, temperature, and time for the extraction of arsenic were investigated based on thermodynamic calculation. The results indicated that the leaching efficiency of arsenic reached 95.6% under the optimized leaching conditions: 80 g/L of NaOH concentration, 1.0 MPa of oxygen partial pressure, 8 mL/g of liquid-to-solid ratio, 120 °C of temperature, 2.0 h of time. Meanwhile, the leaching efficiencies of antimony, cadmium, indium and lead were less than 4.0%, basically achieving the selective separation of arsenic from lead smelter flue dust. More than 99.0% of arsenic was converted into calcium arsenate product and thus separated from the leach solution by a causticization process with CaO after other metal impurities were removed from the solution with the addition of Na2S. The optimized causticization conditions were established as: 4.0 of the mole ratio of calcium to arsenic, temperature of 80 °C, reaction time of 2.0 h. The resulting product of calcium arsenate may be used for producing metallic arsenic.