The present study aims to determine the relationship between the concentration of arsenic in the groundwater of Hamadan province and the mortality rate due to various types of malignancies, congenital anomalies, diabetes mellitus and Alzheimer's. Mortality data due to various causes of death in Hamadan province were collected for five years (2016–2020). Sampling of drinking water was determined in the reference laboratory using polarography method. Poisson regression was used to investigate the relationship between arsenic level and the death rate due to various types of disease, at a significant level (p value < 0.05). According to the results of Poisson regression, among the various causes of death (N = 8042), Alzheimer's 5.94 (3.67–9.61), diabetes mellitus 4.05 (3.5–5.37), congenital malformations 2.98 (1.88–4.72), breast cancer 2.72 (1.56–4.71), leukemia 1.90 (1.24–2.92), stomach cancer 1.64 (1.28–2.10), Liver cancer 1.58 (1.58–2.30), other digestive organs 5.86 (3.38–10.16), meninges and brain cancer 1.57 (1.02–2.41) showed the highest relationship with arsenic contamination. The results of this study could be evidence for a positive and significant relationship between arsenic concentrations and mortality rates due to cancers, diabetes mellitus, Alzheimer disease, and congenital malformations. Therefore, it's necessary to use appropriate water treatment methods to remove arsenic at the source in contaminated areas.