Drinking water mingled with high rate of fluoride makes bone related diseases incurable but a bit of fluoride in drinking water helps to prevent tooth decay. That means, high level of fluoride in drinking water can cause tooth damage and enough level brings skeletal damage which is called skeletal fluorosis. Skeletal fluorosis is called bone disease happened due to intake of excessive fluoride. The fluoride is to be seen on the earth crust and inside of minerals. So the design of fluoride removal plant depends on the amount of fluoride in the pre-filtered water. For that the reason, vessels made of HDPE/FRP are used to filter water. Filters bed are constructed with high quantity of Alumina or ferric hydroxide. Alumina and reverse osmosis system are only two systems to remove fluoride. On the other hand, carbon filters are used to remove fluoride but this is not the correct procedure. KDF or GAC cartridge is the best tool to remover mixed and activated alumina. The system is the best especially in the rural area.