Cadmium (Cd) is a non-essential trace element that is toxic to humans. Previous studies of Cd in the environment have primarily focused on pollution resulted from anthropogenic sources, but little is known on naturally occurring sources of Cd. This paper aims to review the geochemical distribution of geogenic Cd and associated environmental risk. The source, accumulation, mobility, transportation, and health risk of Cd are discussed in a geo-environmental perspective, with an emphasis on black shale soils. Cadmium generally occurs in sulfides in black shale, and is easily released when exposed to oxygen and water. Leaching of these rocks tends to elevate Cd concentrations in aquatic systems, and may pose the potential to produce acid rock drainage (ARD) as well. Weathering of Cd-rich rocks also elevates soil Cd concentrations, and influence the geochemical species of Cd. Crops grown in these soils tend to accumulate higher Cd and threaten the food safety. Local inhabitant exposed to high geogenic Cd via food chains may experience Cd-related health risk. High Cd concentrations are observed in urine, and renal damage is also detected in Cd naturally enriched area based on low molecular weight proteins in urine. Overall, the findings in literature have provided with insights for potential health risk of Cd in areas with high Cd geochemical background levels, particular for the black shale exposed areas, more attentions should be paid on the geogenic Cd pollution, and suitable strategies of remediation and geo-environmental management for geogenic Cd pollution need further research.