Acid sulfate soils have been described as the “nastiest soils on earth” because of their strong acidity, increased mobility of potentially toxic elements and limited bioavailability of nutrients. They only cover a small area of the world's total problem soils, but often have significant adverse effects on agriculture, aquaculture and the environment on a local scale. Their location often coincides with high population density areas along the coasts of many developing countries. As a result, their negative impacts on ecosystems can have serious implications to those least equipped for coping with the low crop yields and reduced water quality that can result from acid sulfate soil disturbance. The Millennium Ecosystem Assessment called on by the United Nations in 2000 emphasised the importance of ecosystems for human health and well-being. These include the service they provide as sources of food and water, through the control of pollution and disease, as well as for the cultural services ecosystems provide. While the problems related to agriculture, aquaculture and the environment have been the focus of many acid sulfate soil management efforts, the connection to human health has largely been ignored. This paper presents the potential health issues of acid sulfate soils, in relation to the ecosystem services identified in the Millennium Ecosystem Assessment. It is recognised that significant implications on food security and livelihood can result, as well as on community cohesiveness and the spread of vector-borne disease. However, the connection between these outcomes and acid sulfate soils is often not obvious and it is therefore argued that the impact of such soils on human well-being needs to be recognised in order to raise awareness among the public and decision makers, to in turn facilitate proper management and avoid potential human ill-health.