Groundwater is a highly important resource, especially for human consumption and agricultural production. This study offers an assessment of groundwater quality in the coastal areas of Sindh province in Pakistan. Fifty-six samples of groundwater were taken at depths ranging from 30 to 50 m. Bacteriological and physico-chemical analyses were performed using the Standard Methods for the Examination of Water and Wastewater. These were supplemented with expert interviews and observations to identify the usage of water and potential sources of pollution. The quality of the groundwater was found to be unsuitable for human consumption, despite being used for this purpose. The concentrations of sulfate and phosphate were well within the tolerance limits. Most critical were the high levels of organic and fecal pollution followed by turbidity and salinity. Metal concentrations (As, Ca, Cr, Cu, Fe, Mg, Mn, Ni, Pb, and Zn) were also determined, and Ni and Pb strongly exceeded health standards. The study stresses the need for significant improvements of the irrigation, sanitation, and sewage infrastructure.