Rice (Oryza sativa L.) is primary dietary source for half of the global population that comprising both essential nutrients and toxic heavy metal elements for human health. A number of nutrients are required within the diet and generally lacking in human diets, and need to biofortify into the rice grains, such as iron (Fe), zinc (Zn), calcium (Ca), potassium (K), sodium (Na), magnesium (Mg), phosphorus (P), copper (Cu), iodine (I), selenium (Se), and Sulphur (S). Meanwhile, some elements are toxic to human, including arsenic (As), cadmium (Cd), chromium (Cr), cobalt (Co), mercury (Hg), manganese (Mn), nickel (Ni), and lead (Pb) which need to be eliminated from the rice grains. This article reviews the aspects of phenotypic variation of grain elemental concentration in the diverse rice genotypes, relationship of environmental conditions and rice grain elemental accumulation, correlation between rice grain elemental content and others agronomic traits, and also genetic basis of grain elemental concentration in rice. All of these aspects are important to develop rice varieties with a balanced elemental nutrients and lower toxic heavy metal elements. Enhancing the concentration of essential mineral elements and reducing the accumulation of toxic elements in the rice grain are important to improve the rice quality for human health in addressing mineral deficiency and toxicity that could be accomplished by using plant breeding, agronomic, and genetic engineering approaches.