Although there are many studies on effect of fluoride on trace elements in experimental animals, few studies exist on serum trace elements levels in patients with endemic fluorosis. We aimed to determine the serum levels of trace elements including serum copper (Cu), zinc (Zn), and serum levels of minerals including calcium (Ca), phosphorus (P), magnesium (Mg), sodium (Na), potassium (K) in patients with endemic fluorosis. The study group consisted of 30 patients with endemic fluorosis (17 females, 13 males, mean age 33.53 +/- 9.85 years). An age, gender, and body mass index matched 30 healthy volunteers comprised control group (21 females, ten males with a mean age 33.93 +/- 7.39 years). Urine fluoride levels of chronic fluorosis patients were significantly higher than that of control subjects as expected (1.92 +/- 0.10 mg/l vs. 0.41 +/- 0.09 mg/l, respectively; P < 0.001). Serum Cu levels (89.14 +/- 16.77 mu g/dL vs. 102.69 +/- 25.04 mu g/dL, respectively, P = 0.017), serum Zn levels (77.98 +/- 20.58 mu g/dL vs. 94.57 +/- 35.87 mu g/dL, respectively, P = 0.032), and serum Mg levels (1.92 +/- 0.18 mg/dL vs. 2.07 +/- 0.31 mg/dL, respectively, p = 0.022) was significantly lower in chronic fluorosis patients than in controls. There were no statistically significant differences between the fluorosis group and control group with respect to serum levels of Na, K, Ca, and P. We concluded that chronic fluorosis is associated with reduced serum levels of Cu, Zn, and Mg.