<p>Fluoride (F⁻) is the most reactive inorganic pollutant found in groundwater resources. An excessive and prolonged exposure to it causes detrimental non-carcinogenic and carcinogenic health impacts. F⁻ is exposed through three different pathways: ingestion (via fluoridated water, food, and dental products), dermal adsorption (via bathing or showering water), and inhalation (via dust or fumes in fluoride-related industries affecting workers). This review is a comprehensive literature review, systematically collecting and analysing relevant studies describing the status of various exposure routes through which it enters the food chain and thereby causing various health impacts. Human health risk assessment framework predicts the overall risk to human health by methodically identifying possible risks, analysing their potential harmful effects, determining the degree of exposure to those risks, and finally describing the overall risk to human health by calculating overall hazard quotient (HQ_overall). We also highlight that uncertainties must be considered while quantifying risk estimates that will help policy makers to identify the most influential variables and better understand the impact of risk. Excess fluoride content in groundwater (&gt; 1.5&#xa0;mg L⁻¹) poses health risks, particularly to children and males. Hence, it is imperative to develop effective treatment methods to eradicate F⁻ contaminants from groundwater. In a nutshell, this article helps to firstly understand the problem deeply and relates this to finding the best possible treatment method, suggesting that among various defluorination methods, adsorption—especially with carbon-based nano adsorbents—is the most effective. Here, it is also mentioned that effective control requires monitoring, public awareness, and anthropogenic emission reduction. Field testing and further research are needed for scalable solutions and safe effluent disposal.</p>