This chapter aims at enhancing progress towards access to safe drinking water through consolidating knowledge in groundwater fluoride occurrence, effects of fluoride on human health, and technologies available for water defluoridation in East and Southern Africa. Specifically the chapter provides information on fluoride occurrence in Eastern and Southern Africa and respective health effects to guide choices and decisions in water supply and treatment at municipal, regional and national level; consolidates research findings in water fluoride and defluoridation science for scientists and non-scientists that will assist in choices of water defluoridation technologies at home or local community and; exemplifies research in special water treatment technologies through water defluoridation science for students in water resource sciences.