<p>Groundwater contamination in coal mining areas poses a significant risk to human health and agriculture production systems. However, the magnitude of heavy metals contamination, associated health risks and irrigation suitability remains poorly documented in developing regions. This study comprehensively evaluated the groundwater quality in an important coal mining region of Balochistan by employing hydro chemical characterization, pollution indexing, irrigation indexing and quantitative health risk assessment. Results showed that most of the physicochemical parameters were in the potable water standards except EC, TDS, Cr, Pb and Cd as per WHO standards. The Heavy Metal Pollution Index (HPI) showed&#xa0;contamination in 54% of the samples (HPI &gt; 100). The WQI categorized 62% of samples as potable to good, while 38% of the samples were in poor to unfit category. The HHRA demonstrated substantial risk due to Cr, Pb and Cd with greater susceptibility of non-carcinogenic and carcinogenic risk to children’s population followed by adults. Gibbs plot analyses revealed that rock–water interactions and evaporation are the major processes that govern groundwater chemistry in the region. The piper plot showed that water types are mixture of (Ca⁺²–Na⁺–HCO₃⁻) and (Ca⁺²–HCO₃⁻). Based on standard indices (%KR, %Na), the evaluation of groundwater suitability for irrigation showed that 55–61.5% of the samples lie in doubtful to unsuitable range. These findings underscore the urgent need for groundwater monitoring, sustainable management and mitigation practices to reduce contamination and safeguard the water quality and public health in the study area.</p>