The aim of the present study is to locate and decipher the groundwater quality, types, and hydrogeochemical reactions, which are responsible for elevated concentration of fluoride in the Chhindwara district in Madhya Pradesh, India. Groundwater samples, quality data and other ancillary information were collected for 26 villages in the Chhindwara District, M.P. India during May 2006. The saturation index was computed for the selected samples in the region, which suggest that generally most of the minerals are saturated with respect to water. The concentration of fluoride in the region varies from 0.6 to 4.74 mg/l, which is much higher as per the national and international water quality standards. The study also reveals that the fluoride bearing rock formations are the main source of the higher concentration of fluoride in groundwater along with the conjuncture of land use change. Moreover, the area is a hard rock terrain and consists of fractured granites and amygdaloidal and highly jointed compact basalt acting as good aquifer, which is probably enriching the high content of fluoride in groundwater. High concentration of fluoride is found in deeper level of groundwater and it is possible due to rock-water interaction, which requires further detailed investigation. The highly alkaline conditions indicate fluorite dissolution, which works as a major process for higher concentration of fluoride in the study area. The results of this study will ultimately help in the identification of risk areas and taking measures to mitigate negative impacts related to fluoride pollution and toxicity.