Rapid urbanization worldwide, poses numerous environmental challenges between escalating land use land cover (LULC) changes and groundwater quality dynamics. The main objective of this study was to investigate the dynamics of groundwater quality and LULC changes in Sargodha district, Punjab, Pakistan. Groundwater hydrochemistry reveals acceptable pH levels (<8) but total dissolved solids (TDS), electrical conductivity (EC) and HCO3− showed dynamic fluctuations by exceeding WHO limits. Piper diagrams, indicated dominance by magnesium and bicarbonate types, underscoring the influence of natural processes and anthropogenic activities. Major ion relationships in 2010, 2015, and 2021 showed a high correlation (R2 > 0.85) between Na+ and Cl−, suggesting salinization. whereas, the poor correlation (<0.17) between Ca2+ and HCO3− does not support calcite dissolution as the primary process affecting groundwater composition. The examination of nitrate contamination in groundwater across the years 2010, 2015, and 2021 was found to be high in the municipal sewage zone, suggesting a prevailing issue of nitrate contamination attributed to urban activities. The Nitrate Pollution Index (NPI) reveals a concerning trend, with a higher proportion of samples classified under moderate to high pollution categories in 2015 and 2021 compared to 2010. The qualitative assessment of nitrate concentration on spatiotemporal scale showed lower values in 2010 while a consistent rise from 2015 to 2021 in north-east and western parts of district. Likewise, NPI was high in the north-eastern and south-western regions in 2010, then reduced in subsequent years, which may be attributed to effective waste management practices and alterations in agricultural practices. The health risk assessment of 2010 indicated Total Health Hazard Quotient (THQ) within the standard limit, while in 2015 and 2021, elevated health risk was observed. This study emphasizes the need to use multiple approaches to groundwater management for sustainable land use planning and regulations that prioritize groundwater quality conservation.