Highly toxic sodium cyanide (NaCN) is used by the international mining community to extract gold and other precious metals through milling of high-grade ores and heap leaching of low-grade ores (Korte et al. 2000). The process to concentrate gold using cyanide was developed in Scotland in 1887 and was used almost immediately in the Witwatersrand gold fields of the Republic of South Africa. Heap leaching with cyanide was proposed by the U.S. Bureau of Mines in 1969 as a means of extracting gold from low-grade ores. The gold industry adopted the technique in the 1970s, soon making heap leaching the dominant technology in gold extraction (Da Rosa and Lyon 1997). The heap leach and milling processes, which involve dewatering of gold-bearing ores, spraying of dilute cyanide solutions on extremely large heaps of ores containing low concentrations of gold, or the milling of ores with the use of cyanide and subsequent recovery of the gold-cyanide complex, have created a number of serious environmental problems affecting wildlife and water management. In this account, we review the history of cyanide use in gold mining with emphasis on heap leach gold mining, cyanide hazards to plants and animals, water management issues associated with gold mining, and proposed mitigation and research needs.