Groundwater contamination by uranium, largely controlled by lithological and geogenic factors, has emerged as a significant public health concern due to its dual radiological and chemical toxicities. This study quantifies uranium concentrations in groundwater across the geologically diverse Ladakh region of the northwestern Himalayas, India, employing an LED fluorimeter (LF-2a). The predominant role of groundwater in meeting drinking, household, and agricultural water demands highlights the importance of evaluating uranium contamination and its potential implications for human health and food security. A total of 73 groundwater samples were analyzed, yielding an average uranium concentration of 2.6 µg/L. Only one sample exceeded the United States Environmental Protection Agency permissible limit of 30 µg/L, while all measured concentrations remained below the Atomic Energy Regulatory Board (India) guideline value of 60 µg/L. Radiological dose estimation revealed that males exhibited higher exposure levels (15.71%) than females, particularly among older age groups, followed by children and infants. Among all tissues, the Lung and Stomach exhibit the highest dose across every age-group. Chemical risk assessments showed no non-carcinogenic concerns, with all exposure levels of in lifetime average daily dose remaining far below the reference limit of 4.4 µg/kg/day suggested by Atomic Energy Regulatory Board. The physicochemical results also suggest that spring water‒naturally low in dissolved salts and largely sourced from snow melt, is the safest option for drinking, while well and hand-pump water carries higher ionic content and possible contamination. Overall, the findings underline the importance of ongoing groundwater monitoring and holistic risk assessments to protect safe drinking water and public health across the Himalayan region.