Historically, the severity and typology of socio-economic and political significance of Telangana fluoride problem cannot be seen anywhere in the world. Nalgonda district as the epicenter, people with stooped backs, crooked hands and legs, deformed teeth, blindness and crippling disabilities; the picture of fluorosis in Telangana is a horrifying one. This problem used to be more prevalent in rural areas surrounding the district. In recent times, the fluoride levels in many towns and cities including Hyderabad and Secunderabad are gradually rising. Increased industrial effluents are causing elevated fluoride levels in surface water and increasing fluoride level in ground water is due to the bore wells that are dug very deeper. Intensified industrialization in Warangal, Ranga Reddy, Medak, Mahabubnagar, and Nalgonda districts of Telangana pushed by development thrust should not be compromised at the cost of people’s health.