Groundwater contamination poses a severe public health risk in Lahore, Pakistan’s second-largest city, where over-exploited aquifers are the primary municipal and domestic water supply source. This study presents the first comprehensive district-wide assessment of groundwater quality across Lahore using an innovative integrated approach combining geographic information systems (GIS), multi-criteria decision analysis (MCDA), and water quality indexing techniques. The core objectives were to map the spatial distributions of critical pollutants like arsenic, model their impacts on overall potability, and evaluate targeted remediation scenarios. The analytic hierarchy process (AHP) methodology was applied to derive weights for the relative importance of diverse water quality parameters based on expert judgments. Arsenic received the highest priority weight (0.28), followed by total dissolved solids (0.22) and hardness (0.15), reflecting their significance as health hazards. Weighted overlay analysis in GIS delineated localized quality hotspots, unveiling severely degraded areas with very poor index values (>150) in urban industrial zones like Lahore Cantt, Model Town, and parts of Lahore City. This corroborates reports of unregulated industrial effluent discharges contributing to aquifer pollution. Prospective improvement scenarios projected that reducing heavy metals like arsenic by 30% could enhance quality indices by up to 20.71% in critically degraded localities like Shalimar. Simulating advanced multi-barrier water treatment processes showcased an over 95% potential reduction in arsenic levels, indicating the requirement for deploying advanced oxidation and filtration infrastructure aligned with local contaminant profiles. The integrated decision support tool enables the visualization of complex contamination patterns, evaluation of remediation options, and prioritizing risk-mitigation investments based on the spatial distribution of hazard exposures. This framework equips urban planners and utilities with critical insights for developing targeted groundwater quality restoration policies through strategic interventions encompassing treatment facilities, drainage infrastructure improvements, and pollutant discharge regulations. Its replicability across other regions allows for tackling widespread groundwater contamination challenges through robust data synthesis and quantitative scenario modeling capabilities.