Exposure to inorganic arsenic (iAS) induces sex-dependent pathological hypertrophy in the heart, in part by activating the calcineurin-nuclear factor of activated T cells (NFAT) pathway. Graphic summary of the major findings in this study. Exposure to 615 μg/L iAS through drinking water for 8 wk was observed to increase left ventricular wall thickness, systolic blood pressure, heart mass normalized to tibia length (HW/TL), plasma atrial natriuretic peptide (ANP), and mRNA expression of the fetal gene program in male hearts. Furthermore, iAS exposure was observed to activate NFAT transcription in HEK-293 cells and stimulate fetal gene expression in neonatal rat ventricular myocytes (NRVMs), which was blocked by inhibiting calcineurin with cyclosporin treatment.