Changes in elemental and mineralogical composition, and lead speciation, of air pollution control residue (APCR) from municipal solid waste incineration, due to treatment by water washing, were investigated in this work and are reported in the context of a review of the literature. Water washing was shown to substantially modify the nature of APCR by: 1) removing 23% dry mass soluble salts to disagglomerate particles and significantly reduce concentrations of the associated major elements, and increase concentrations of insoluble matrix elements and potential pollutants; and 2) respeciating elements to form new phases. X-ray absorption near edge spectroscopy (XANES) showed that the 500 mg/kg of Pb in raw and washed APCR were comprised mainly of Pb-glass, with some PbSO4, and small amounts of PbO and PbCl2. Semi-quantitative linear combination fitting suggests that the glass in the APCR may be unstable and release Pb under the alkaline pH of water washing, to reprecipitate as PbO. Chemical analysis suggests that some Pb may be removed by washing. Scientific understanding of the composition of raw and washed APCR, and particularly the speciation of potentially toxic metals, such as Zn and Pb, can help in developing effective element recovery and residue treatment, utilization or disposal strategies.