<p>The deterioration of groundwater quality is intensifying due to urban growth, anthropogenic influences, and hydrogeochemical processes. This study examines the hydrogeochemical characteristics, spatial variability, and non-carcinogenic health risks of groundwater in the urban and peri-urban areas of Kochi city in Kerala, India. Groundwater samples were collected and analysed during the pre- and post-monsoon seasons and evaluated using multivariate statistical techniques, saturation index analysis, and the entropy-weighted water quality index (EWQI), along with assessments of microbiological contamination and uncertainty analysis through Monte Carlo simulation (MCS). The findings suggest that groundwater chemistry is largely influenced by ion exchange, and mineral dissolution, with Ca²⁺-Mg²⁺-Cl⁻ water type being the most prevalent. Saturation index analysis reveals that carbonate minerals (calcite, aragonite, and dolomite) are supersaturated in few areas, whereas halite, gypsum, and sylvite remain undersaturated, highlighting the role of dissolution processes. The EWQI results indicate that a significant portion of groundwater, particularly in coastal and urban regions, falls within the poor to extremely poor categories for drinking purposes, with additional evidence of <i>Escherichia coli</i> (<i>E.coli</i>) contamination. The health risk assessment, based on the Target Hazard Quotient (THQ) and Hazard Index (HI), identifies children as the most vulnerable group. In pre-monsoon season, 49.39% of groundwater samples exceeded the non-carcinogenic risk threshold, which decreased to 40.19% in the post-monsoon season. MCS results validate these findings, demonstrating that health risks are probabilistically higher in urbanized and coastal areas. This study underscores the critical need for sustainable groundwater management, stricter abstraction regulations, and improved wastewater treatment strategies, particularly in high-risk urban and coastal areas.</p>