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The objective of this study was to investigate and map fluoride distribution patterns of groundwater in the Shush aquifer, Khuzestan County, located in western Iran. The aquifer was divided into four sub-regions according to topsoil type in relation to the direction of groundwater flow. A total of 168 groundwater samples were collected in 4 replicates from 42 wells during April, May, August, and September 2004. Fluoride concentrations measured spectrophotometrically by the SPADNS method ranged from 0.12 to 2.17 mg F/L (mean 0.6±0.44 mg F/L) with the highest levels in the southern-most part of the aquifer. Approximately 40% of the samples exceeded 0.68 mg F/L.