The state known as the bread basket of India has now been defamed as the cancer capital of the country. The toxicity of groundwater associated with the declining water level is reported in recent years. However, an extensive temporal and spatial analysis is required to identify hotspots. In this study, spatial tools are utilized to understand the evolution of groundwater in Punjab (> 315 sites) for the last two decades (2000–2020) for drinking purposes using the water quality index (WQI). The data for pH, electric conductivity (EC), bicarbonate (HCO₃¯), chloride (Cl¯), sulfate (SO₄²¯), nitrate (NO₃¯), fluoride (F¯), calcium (Ca²⁺), magnesium (Mg²⁺), sodium (Na⁺), and potassium (K⁺) collected from the Central Groundwater Board (CGWB) were analyzed. The results show that the average cation abundance is in declining order of Na > Mg > Ca > K, and anion abundance is in order of HCO₃¯ > SO₄²¯ > Cl¯ > NO₃ > F. The ions are compared with water quality standards defined by BIS and WHO. The study shows that in the year 2000, 69.52% of locations are above the acceptable limit for EC, 68.89% for Mg², 84.76% for Na⁺, 51.75% for HCO₃¯, 38.41% for NO₃¯, and 17.20% for F¯. While in the year 2020, 48.89% exceed the acceptable limit for EC, 57.78% for Mg²⁺, 68.25% for Na⁺, 34.92% for HCO₃¯, 27.30% for NO₃¯, and 8.88% for F¯. WQI shows that in the year 2000, 13.01% of sampling locations are categorized as very poor and 20% as unsuitable for drinking. Meanwhile, in 2020, 6.35% of locations are categorized as very poor and 12.38% as unsuitable for drinking in the study area. In addition to the effect on plant growth, consumption of contaminated water can adversely affect human health. The health hazards for F¯ (HQF) and NO₃¯ (HQN) and their total health index (THI) are also evaluated that depicts 244 groundwater sampling sites in the year 2000, and 152 sampling sites in the year 2020 show high non-carcinogenic effects on adults, children, and infants. Southwestern Punjab is found to be the worst affected, while north-eastern regions drained by the Himalayan rivers show better quality water. Shifting in agricultural practices in the last two decades and declining water levels due to excess pumping of water from deeper water tables deteriorated the quality of water in the Southern region as observed from the geospatial analysis.