Background: Ingestion of excess fluoride more than 1 ppm (parts per million) continuously in an endemic area causes fluorosis, a chronic disease due to fluoride intoxication. Fluorosis affects teeth, bone and non skeletal soft tissues in the body. Ingestion of 4 ppm of fluoride in a rural endemic area causes skeletal fluorosis and the clinical findings are analyzed and submitted Materials And Methods: Sengotur an endemic village for fluoride in Salem district of Tamil Nadu, India has been chosen for examination of patients with skeletal fluorosis. Estimation of fluoride in two wells from which the patients drink water was analyzed by iron selective electrode and it was found that the fluoride level of water in one well is 7.5 ppm and another well 5.2ppm. Patients were examined clinically for their appearance, movements of head, rigidity of neck; alterations in the chest, like scoliosis, movements of extremities, walking were examined clinically for a total number of 60 persons with 38 males and 22 females. Results: Rigidity of Neck and Restricted Movements of Skull, Kyphosis of thoracic vertebrae, Scoliosis in the chest, bending downwards to see the floor without seeing the sky, criss cross walking, Joint pains in the upper and lower extremities, Genuvarum with bowing of leg, Crippling state of patient without movement, Paraesthesia and Paraplegia are the findings recorded Conclusion: The study has revealed characteristic of skeletal changes which could be used as clinical diagnostic markers of skeletal fluorosis differentiating from all other osteodystrophies