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Chittur block represents a mid-land region of Palakkad district, Kerala and the block differs from the rest of the blocks in its climate and availability of groundwater. About 75% of the people depend on agriculture for their livelihood. Results showed that groundwater salinity levels (up to 1,963 mg/L TDS), fluoride (up to 6.3 mg/L) and nitrate (up to 141 mg/L) contents have increased significantly in tandem with the increase in groundwater abstraction. Before human intervention the chemical weathering of gneisses and granites was the main process impinging on the chemical signature of groundwater. The initial chemical equilibrium conditions change with increasing groundwater withdrawal rates and fertilizer input, in a milieu of lower natural groundwater recharge. The appearance of higher levels of bicarbonate, linked to denitrification processes, and the decrease in calcium, due to calcite precipitation, can lead to increased content of sodium and fluoride in groundwater. In this scenario the use of groundwater resources for human consumption and agriculture represents a public health risk if water management actions do not change the trend in water use in the near future. The potential loss of fertile soil by groundwater salinization must also be considered when planning sustainable policies in a region with over dependence on groundwater resources.