First-row transition metals play several roles in biological processes and in medicine, but can be toxic in high concentrations. Here the authors comment on the sensitive biochemistry and speciation chemistry of the first-row transition metals, and outline some of the remaining questions that have yet to be answered. Five of the ten first-row transition metals are essential to human health, including manganese, iron, cobalt, copper, and zinc 1,2. Three more first-row transition elements have shown some beneficial biological effects including chromium, vanadium, and nickel. Typically, these metals are consumed in a varied diet or as nutritional additives where, in the human body, they serve both structural and functional roles including the maintenance of cellular functions involved in a wide range of biological activities. However, normal function requires that the levels of the metal ions are maintained within an acceptable range; lower concentrations may result in a nutritional deficiency and higher concentrations may result in toxicity (Fig. 1) 3. In addition, the physical properties of first-row elements, particularly titanium and nickel, are important for preparation of new materials and alloys, resulting in technological advantages that improve the quality of life. Nine of the ten first-row transition metals have densities larger than 5.0 g/cm 3 which, by some definitions, classifies them as 'heavy metals'. Although this definition may be commonly used by some, it is not embraced by chemists primarily because this definition depends on the density of the metal rather than its chemical properties. Furthermore, the negative connotation associated with the term 'heavy metal' and the toxicity of metals such as cadmium and mercury stands in opposition to the fact that five of the first-row transition elements are essential to life. A more concise definition of the vague term 'heavy metal' can be based on chemical properties and would include the block of metals in Groups 3 to 16 that are in periods 4 and greater 4. This definition of 'heavy metals' does not involve first-row elements but only second and third-row transition metals. However, even this definition is debated 4. It is however clear that none of the five essential first-row transition metals are toxic 'heavy metals'. The chemistry of all first-row transition metals is very sensitive to their environment 6. In the presence of water, each metal ion forms hydrated ions which undergo pH and concentrationdependent chemistry that is dictated by the presence of metabolites, proteins, and other biological components (Fig. 1a). It is important to recognize that redox active metal ions do not exist