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There is discrepancy about intervals of fluoride monitoring in groundwater resources by Iranian authorities. Spatial and temporal variability of fluoride in groundwater resources of Larestan and Gerash regions in Iran were analyzed from 2003 to 2010 using a geospatial information system and the Mann-Kendall trend test. The mean concentrations of fluoride for the 8-year period in the eight cities and 31 villages were 1.6 and 2.0 mg/l, respectively; the maximum values were 2.4 and 3.8 mg/l, respectively. Spatial, temporal, and spatiotemporal variability of fluoride in overall groundwater resources were relatively constant over the years. However, results of the Mann-Kendall trend test revealed a monotonic trend in the time series of one city and 11 villages for the 8-year period. Specifically, one city and three villages showed positive significant Kendall's Tau values, suggesting an upward trend in fluoride concentrations over the 8-year period. In contrast, seven villages displayed negative significant Kendall's Tau values, arguing for a downward trend in fluoride concentrations over the years. From 2003 to 2010, approximately 52 % of the Larestan and Gerash areas have had fluoride concentrations above the maximum permissible Iranian drinking water standard fluoride level (1.4 mg/l), and about 116,000 people were exposed to such excess amounts. Therefore, our study supports for a close monitoring of fluoride concentrations from health authorities in monthly intervals, especially in villages and cities that showed positive trend in fluoride concentrations. Moreover, we recommend simultaneous implementation of cost-effective protective measures or interventions until a standard fluoride level is achieved.