The purpose of this study was to evaluate the refractive errors and the demographic associations between drinking water with excessive fluoride and normal drinking water among residents in Northern China. Of the 1843 residents, 1415 (aged ?40 years) were divided into drinking-water-excessive fluoride (DWEF) group (>1.20 mg/L) and control group (?1.20 mg/L) on the basis of the fluoride concentrations in drinking water. Of the 221 subjects in the DWEF group, with 1.47?±?0.25 mg/L (fluoride concentrations in drinking water), the prevalence rates of myopia, hyperopia, and astigmatism were 38.5 % (95 % confidence interval [CI]?=?32.1-45.3), 19.9 % (95 % CI?=?15-26), and 41.6 % (95 % CI?=?35.1-48.4), respectively. Of the 1194 subjects in the control group with 0.20?±?0.18 mg/L, the prevalence of myopia, hyperopia, and astigmatism were 31.5 % (95 % CI?=?28.9-34.2), 27.6 % (95 % CI?=?25.1-30.3), and 45.6 % (95 % CI?=?42.8-48.5), respectively. A statistically significant difference was not observed in the association of spherical equivalent and fluoride concentrations in drinking water (P?=?0.84?>?0.05). This report provides the data of the refractive state of the residents consuming drinking water with excess amounts of fluoride in northern China. The refractive errors did not result from ingestion of mild excess amounts of fluoride in the drinking water.