Studies have suggested that fluoride might be associated with alteration in reproductive hormone levels, infertility, Down's syndrome, increased rate of congenital anomalies and cancers. There is an increased concentration of congenital anomalies in north-west India, however, no studies are available regarding the possible association with fluoride. In the present study, serum fluoride levels were explored in cord blood of newborns with visible congenital anomalies (n=30) and in healthy newborns (n=30). The detailed history of present pregnancy, the status of the baby (birth order, previous stillbirth, details of defects and handicaps), nutritional status of parents (deficiency, if any), history of pesticides or heavy metal exposure of parents, history of use of any medication (prior or during pregnancy). Detailed examination of babies, in terms of site of the defect, the neurological deficit was also recorded. Five mL cord blood was collected from the placental end of the umbilical cord after delivery of baby and serum was separated and routine biochemistry investigation was performed by autoanalyzer. Serum fluoride levels were analyzed by ISE in cord blood of both the groups. In the present study, cord blood fluoride levels were higher in babies with congenital anomalies as compared to healthy controls. Fluoride crosses the placenta and gets incorporated into tissues of developing conceptus. Chronic exposure to high fluoride levels may produce harmful effects on developing fetus especially brain and heart, thyroid and increased future risk of cancer. Thus, findings of the present study suggest that fluoride in pollution exposures (agricultural and industrial) in this region might be a causative factor in congenital anomalies in this region.