Abstract：Exemplified by the result of endemic and eco-geochemical investigation in several cities of the lower Yellow River basin within Shandong Province, the authors studied the relationship between endemic fluoride disease and geological environment. It is shown that endemic fluoride disease has close relationship with soil and potable water. Based on a review of the past work on the prevention and treatment of local endemic fluoride disease as well as the existent problems, this paper suggests that the investigation and study of specialized endemic geological work should be carried out as soon as possible.