© 2020 Bauxite residue is typically alkaline, has high sodium content and elevated concentrations of trace elements. Effective rehabilitation strategies are needed to mitigate potential environmental risks from its disposal and storage. Increasingly, the importance of viable soil faunal populations as well as establishment of vegetation covers is recognized as key components of successful rehabilitation. Inoculation with earthworms is a strategy for accelerating mine site rehabilitation, but little is known on the effects of bauxite residue properties on earthworm survival and viability. In the current study, earthworms (Eisenia fetida) were exposed for 28 days to a series of bauxite residue/soil treatments (0, 10, 25, 35, 50, 75 and 100% residue) to evaluate possible toxic effects on earthworms, investigate the bioavailability of relevant elements (e.g. As, Cr, V), and assess the risk of element transfer. Results showed that soil containing ¿25% residue (pH ¿ 9.8; ESP ¿ 18.5%; extractable Na ¿ 1122 mg/kg) significantly impacted survival (mortality ¿28%) and reproduction (cocoon production inhibition ¿76%) of the exposed earthworms. Alkalinity, sodicity and bioavailable Na were identified as major factors causing toxicity and some earthworms were observed to adopt compensative response (i.e. swollen body) to cope with osmotic stress. Conversely, soil containing 10% residue (pH = 9.1; ESP = 9.2%; extractable Na = 472 mg/kg) did not elicit significant toxicity at the organism level, but biomarker analysis (i.e. superoxide dismutase and catalase) in earthworm coelomocytes showed an oxidative stress. Furthermore, earthworms exposed to soil containing ¿10% residue took up and accumulated elevated concentrations of Al, As, Cr and V in comparison to the control earthworms. We concluded that earthworm inoculation could be used in future rehabilitation programmes once the key parameters responsible for toxicity are lowered below specific target values (i.e. pH = 9.1, ESP = 18.5%, extractable Na = 1122 mg/kg for Eisenia fetida). Nonetheless, trace element uptake in earthworms should be regularly monitored and the risk to the food chain further investigated.