Groundwater plays a crucial role in regions like southern Uzbekistan, where surface water is limited. This study investigates the physico-chemical properties of groundwater in the Koson district (Kashkadarya region) to assess its suitability for drinking and sustainable use. Four samples (S1–S4) collected from different depths (100–1650 m) were analyzed for pH, electrical conductivity (EC), total alkalinity, total hardness (TH), calcium hardness (CaH), magnesium hardness (MgH), and total dissolved solids (TDS). Ionometric and elemental analyses were also conducted using standard methods, including ICP-MS. While all samples had a pH within WHO-recommended limits (6.5–8.5), EC, TDS, and hardness values exceeded permissible levels in most cases. Sample S2 recorded the highest EC (6295 µS/cm) and TDS (7600 mg/L), indicating excessive salinity. Total hardness in some samples reached up to 930 mg/L, suggesting unsuitable conditions for direct consumption. Elemental analysis revealed relatively high sodium, calcium, and magnesium levels, though within safe limits. Ionometric data indicated possible contamination from agricultural and anthropogenic sources, including elevated nitrate (NO₃⁻) and ammonium (NH₄⁺) levels. The findings suggest that while groundwater can be a critical water source, proper treatment is required before use. Regular monitoring and management are essential to prevent health risks and ensure long-term water sustainability in the region.