Red mud leachate (pH 13) collected from Ajka, Hungary is neutralised to < pH 10 by HCl, gypsum or seawater addition. During acid neutralisation >99 % Al is removed from solution during the formation of an amorphous boehmite-like precipitate and dawsonite. Minor amounts of As (24 %) are also removed from solution via surface adsorption of As onto the Al oxyhydroxides. Gypsum addition to red mud leachate results in the precipitation of calcite, both in experiments and in field samples recovered from rivers treated with gypsum after the October 2010 red mud spill. Calcite precipitation results in 86 % Al and 81 % As removal from solution, and both are non-exchangeable with 0.1 mol L-1 phosphate solution. Contrary to As associated with neoformed Al oxyhydroxides, EXAFS analysis of the calcite precipitates revealed only isolated arsenate tetrahedra with no evidence for surface adsorption or incorporation into the calcite structure, possibly as a result of very rapid As scavenging by the calcite precipitate. Seawater neutralisation also resulted in carbonate precipitation, with >99 % Al and 74 % As removed from solution during the formation of a poorly ordered hydrotalcite phase and via surface adsorption to the neoformed precipitates, respectively. Half the bound As could be remobilised by phosphate addition, indicating that As was weakly bound, possibly in the hydrotalcite interlayer. Only 5-16 % V was removed from solution during neutralisation, demonstrating a lack of interaction with any of the neoformed precipitates. High V concentrations are therefore likely to be an intractable problem during the treatment of red mud leachates.