Groundwater qualityGroundwater quality in the KwaZulu-Natal coastal region of South Africa faces escalating threats from rapid land use and land cover (LULC) changes driven by urbanizationUrbanization, agricultural expansion, and deforestation. This chapter investigates the spatiotemporal dynamics of LULC transformations between 2001, 2013, and 2023 using Landsat imagery and GIS techniques, and evaluates their impacts on groundwater quality. Six LULC classes, i.e., agricultural land, built-up areas, forests, bushland, barren land, and water bodies, were analyzed, revealing significant increases in agricultural (24 to 29%) and urbanized areas (0.3 to 1.2%), alongside declines in bushland (45 to 33%). Groundwater quality parameters, including physicochemical properties, major ions, and trace metals, were assessed against WHO standards. Key findings identified elevated levels of electrical conductivity (EC), total dissolved solids (TDS), chloride (Cl–), sodium (Na+), and lead (Pb) in agricultural and urban zones, correlating with anthropogenic activities like fertilizer use and industrial runoff. Forests, primarily commercial plantations, exhibited high sulfate and chloride concentrations, while barren lands showed minimal contamination. Statistical analyses (Kruskal–Wallis tests) confirmed significant variations in contaminants across LULC classes, emphasizing the role of land use in water quality degradation. The study underscores the urgent need for integrated land management policies, sustainable agricultural practices, and continuous monitoring to mitigate contamination risks and safeguard groundwater resources in this ecologically sensitive coastal region.