Groundwater is largely consumed for drinking in arid and semi-arid regions, but it is vulnerable to contamination from both geogenic and anthropogenic sources. This necessitates a thorough assessment of its quality. This study investigates fluoride (F−) contamination in the groundwater of Haryana, a semi-arid region of North-West India, where higher concentrations of F− are frequently reported. The study is conducted to evaluate the distribution, genesis, and mobilization of F− contamination and highlights F− hotspot areas. Literature review suggests that the F− value upto 86 mg L−1 was reported from the groundwater of Haryana, exceeding 50+ times higher than the WHO safe limit (1.5 mg L−1). Potential health risks from F−-contaminated groundwater in Haryana were assessed using total hazard quotient (THQ) for two major subgroups, i.e., children and adults. THQ shows an alarming value for both subgroups, with THQ ranging from 1.58 to 85 for children and 0.80 to 43 for adults, respectively. Results reveal that a significant portion of population in Haryana is exposed to chronic fluorosis, and children are more vulnerable to fluorosis than adults. The study found that the communities are unintendedly drinking contaminated groundwater, raising a potential concern to public health. The study also explores local remedial techniques adopted in North-West India (Haryana and Rajasthan). Finally, the study highlights knowledge gaps in understanding F− contamination across Haryana and emphasizes the urgent need for revised policies on groundwater contamination to mitigate the risk of fluorosis.