Abstract Background Gas extraction in the Dutch province of Groningen began in 1963 and was initially seen as an economic boon for the nation. Yet, it turned into a significant burden for the region, leading to earthquakes, damage to houses and property, complicated compensation processes, recovery, and reinforcement programs, as well as a lack of recognition. In 2016, the research group Gronings Perspectief (GP) was established with the objective of independently monitoring the public health and safety impact of the gas-extraction crisis from the residents’ perspective. Methods Monitoring activities take place in dialogue with sounding boards comprising residents, professionals, scientists, and local and national governments. GP employs a longitudinal mixed-methods approach, combining qualitative and quantitative research methods. Representative panel surveys are conducted yearly among residents in the provinces of Groningen (twice) and Drenthe (once). Additionally, 20 in-depth interviews are carried out each year, alongside a survey among households in the reinforcement program. GP analyses the periodic health monitors conducted by municipal health authorities. All reports are publicly accessible. Results Since 2016, monitoring consistently points to a profound and enduring effect of housing damage on health and well-being, subjective safety, risk perceptions, trust in governments and agencies among residents. The impact of the procedural burden imposed by governments and institutions, is as significant as the effects of earthquakes and housing damage. Conclusions GP’s findings were included in a parliamentary inquiry, which concluded in 2023 that the interests of residents were persistently neglected in favour of economic gain. New risk reduction and reconciliation programs are introduced. Despite the recent decision to end the gas extraction, continuation of GP is needed to monitor further developments. Key messages • GP’s stakeholder-driven monitoring approach made the impact of the gas-extraction crisis visible. • Enduring public health and safety risks, beyond the gas extraction, require continuing monitoring.