Introduction Mercury is used to extract the gold from the ore in artisanal small-scale gold mining areas (ASGM). The toxic mercury is a serious health hazard for miners and the general population. It is estimated that up to 100 million people are exposed.

Methods An extensive review of available data sources will be performed and combined with results of our own health assessments in ASGM.

Results Miners show tremor, ataxia and other neurological symptoms together with a raised body burden of mercury. Many of them were diagnosed with chronic inorganic mercury vapour intoxication. Children and the general population in mining areas show similar symptoms and have increased mercury levels. 14–19 million miners work globally, between 25% and 33% of those miners are intoxicated.

Conclusions ASGM is causing severe negative health effects for miners and their families including children. Political action is needed to address those issues and to reduce the exposure with mercury in ASGM. Possible interventions are mercury free gold mining methods which are available. The health care sector needs to be strengthened to be able to diagnose and treat mercury intoxications. Further research is needed to analyse the specific health hazards of pregnant women, and infants.