The purpose of this study was to evaluate parameters of drinking water quality from hand-pumps in Ghana, Mali, and Niger, evaluate possible sources of parameters, and provide an overview of potential health effects in the population. Concentrations of 22 parameters in 3337 groundwater samples were analyzed and compared with World Health Organization drinking water guidelines. In general, F, Mn, and Al had relatively larger and more common rates of occurrence, though there was by country. For F, there were reports of skeletal fluorosis in Niger and dental fluorosis in Ghana. For Mn and Al it was difficult to assess health effects due to scarce information.