Study region: This review focuses on major uranium-producing arid regions, including Australia, Chile, Kazakhstan, the USA, Niger, South Africa, and Namibia. These regions are globally significant not only for their uranium deposits but also because communities rely heavily on groundwater as a primary drinking water source. Study focus: The paper synthesises existing knowledge on the occurrence of uranium in groundwater across these arid environments, examining its impacts on water quality and associated health risks. It further evaluates available remediation technologies and considers their applicability under diverse hydrogeological and socio-economic settings. Unlike previous studies limited to individual sites or countries, this review provides a cross-regional comparison that integrates hydrochemical, radiological, and remediation perspectives. New hydrological insights for the region: The analysis reveals recurring hydrogeochemical challenges in arid uranium provinces, particularly the limited application of isotopic tracers, radionuclide monitoring, and advanced groundwater modelling. By comparing case studies across continents, the review identifies consistent knowledge gaps and emphasises that remediation strategies must be tailored to local hydrogeology and cost constraints. This synthesis presents a novel global perspective on understanding uranium-related groundwater risks in arid regions and outlines a roadmap for future research and adaptive water management.