Preliminary investigation reveals that fluorosis is reported due to the continuous intake of fluoride-rich groundwater in Vattamalikarai River basin, Tamil Nadu, India. A detailed study was attempted for evaluating the health risks associated with the intake of fluoride-rich groundwater supplied to the rural community. Groundwater samples were collected from 60 and 58 dug and tube wells during winter and southwest (SW) monsoon seasons respectively. The samples were analyzed for the determination of fluoride and other chemical parameters to examine the fitness for drinking water. Spatio-temporal variation maps reveal that fluoride concentration is high during SW monsoon season when compared with the winter season in this region. The fluoride bearing minerals present in hornblende-biotite gneiss and charnockite rock formations leached into the groundwater during rock-water interaction. To understand the subsurface hydrogeochemical reactions, inverse mass balance model was developed using NETPATH code. The model output indicates that calcite dilution, silicate (hornblende and biotite) weathering, ion exchange (Ca/Na and Mg/Na) and illite precipitation are the dominant processes controlling the groundwater chemistry along the flow paths. Non-carcinogenic risks to children and adults (women and men) were evaluated by working out intake exposure of groundwater. Hazard quotient (HQ) based on fluoride intake was calculated for children and adults. It varied from 0.08 to 2.21 with an average of 1.07 for adults. For children, it varied from 0.01 to 2.99 with the mean of 1.44. About 78%, 69% and 61% of the samples fall under the risk category for children, women and men during winter season. However, more number of samples possessed health risks (83% of samples for children, 73% of samples for women and 64% of samples for men) during SW monsoon season.