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The island of Ischia belongs to the active volcanic area of Naples. It is formed from Quaternary volcanic rocks and exhibits intense hydrothermal activity, which is manifested through numerous springs, fumaroles and sporadic geysers. The content of minor and trace elements in groundwater has been analyzed, including some elements that are considered toxic for humans. Mean concentrations of As, B, Fe, Mn, Sb, and Se in samples from 43 aquifer points exceed the WHO recommended values and the limits set by European and Italian legislation (98/83/CE and DM 471, respectively). In general, the spatial distribution of the elements follows a common pattern: it is governed by a marked structural control, which favors hydrochemical processes that liberate the elements into the water.