Objective: To explore the effect of water fluoride levels on teeth and  renal function  in the endemic fluoride areas in YSR Kadapa district Method: A cross sectional study was conducted in 6 villages of YSR Kadapa district . 659 people  were assessed in terms of drinking water fluoride levels and  dental fluorosis. Fluoride concentrations in urine and  creatinine  level in serum  were determined. Results: Water fluoride levels were ranging from 1.4mg/l to 4.2mg/l in the collected water samples in the study area in YSR district The study population consisted of 659 participants 363(55.08%)were with dental fluorosis and 296(44.91% ) were without dental fluorosis. There is no much difference in levels of  urinary fluoride and serum creatinine of dental fluorosis people and non dental fluorosis people residing in the study area. Serum creatinine  level significantly increased in the study population than normal reference range. Conclusion: Our study results, prevalence of dental fluorosis and higher serum creatinine levels than reference range in the subjects suggests that long-term fluoride exposure is associated with kidney dysfunction in adults. The damage degree increases with the duration of the drinking water fluoride content. Renal damage degree is related  to water fluoride concentration but not to the dental fluorosis suffering or not in the study population.