Tens of millions of people living in 50 odd countries around the world are affected by endemic skeletal fluorosis. It is a major public health problem mostly in developing countries of Asia and Africa. Fluorosis is also spreading and becoming more severe in many countries such as India. It is predominantly a rural problem and hence did not get the proper attention of the rulers of those countries. The majority of rural population is dependent upon ground waters which are getting depleted year by year. The main reason for endemic fluorosis is the failure of governments in providing potable water for drinking and cooking to rural population. In high endemic areas the locally cultivated foods by water containing high levels of fluoride and consumed by the residents also contributes to the fluorosis incidence. Malnutrition due to poverty aggravates the condition. Fluorosis causes serious social disruptions in the families so afflicted. The book aims to provide an understanding of the endemic disease.