Contamination of groundwater with fluoride represents a significant global issue, with high concentrations posing serious public health threats. While fluoride is a critical element in water, excessive levels can be detrimental to human health and potentially life-threatening. Addressing the challenge of removing fluoride from underground water sources via nanotechnological approaches is a pressing concern in environmental science. To collate relevant information, extensive literature searches were conducted across multiple databases, including Google Scholar, PubMed, Scopus, Web of Science, the American Chemical Society, Elsevier, Springer, and the Royal Society of Chemistry. VOS Viewer software version 1.6.20 was employed for a systematic review. This article delivers an exhaustive evaluation of various groundwater fluoride removal techniques, such as adsorption, membrane filtration, electrocoagulation, photocatalysis, and ion exchange. Among these, the application of nanoparticles emerges as a notable method. The article delves into nano-compounds, optimizing conditions for the fluoride removal process and benchmarking their efficacy against other techniques. Studies demonstrate that advanced nanotechnologies—owing to their rapid reaction times and potent oxidation capabilities—can remove fluoride effectively. The implementation of nanotechnologies in fluoride removal not only enhances water quality but also contributes to the safeguarding of human health.