ABSTRACT This work aimed to perform a biochemical, histological, and immunohistochemical assessment of the influence of sodium fluoride on the adrenal gland of rats and the possible ameliorating role of Dactyloctenium aegyptium (D. aegyptium). Thirty-five male albino rats were divided into five equal groups: group I served as the control group, group II received sodium fluoride (5 mg/kg), group III received D. aegyptium (200 mg/kg), and groups IV and V received sodium fluoride and D. aegyptium (100 and 200 mg/kg respectively) simultaneously for 28 days. Aldosterone, corticosterone, nitric oxide, sodium, potassium, and chloride were measured in serum samples. Adrenal gland specimens were processed for histological, histochemical, and immunohistochemical studies. The sodium fluoride group recorded a significant reduction in serum levels of aldosterone, corticosterone, potassium, and chloride (p ≤ 0.0001) and a significant increase in nitric oxide (p ≤ 0.0001) and serum sodium (p = 0.0076) when compared with the control group. Histological changes in the sodium fluoride treated group showed cytoplasmic vacuolation, scattered apoptotic cells, and hemorrhage. The sodium fluoride treatment significantly decreased glycogen (p = 0.0002), total protein) p = 0.0007), and DNA (p ≤ 0.0001) and increased inducible nitric oxide synthase (p = 0.0001). Co-treated groups with D. aegyptium showed almost average values for most parameters and a nearly standard architecture. The present data answers the question of our research that D. aegyptium ethanolic extract could protect against sodium fluoride’s adverse effects in rat adrenal glands on the physiological and histological levels.