This study examined the feasibility of nanofiltration (NF) and reverse osmosis (RO) in treating challenging natural tropical waters containing high fluoride and natural organic matter (NOM). A total of 166 water samples were collected from 120 sources within northern Tanzania over a period of 16 months. Chemical analysis showed that 81% of the samples have fluoride levels exceeding the WHO drinking guideline of 1.5mg/L. The highest fluoride levels were detected in waters characterized by high ionic strength, high inorganic carbon and on some occasions high total organic carbon (TOC) concentrations. Bench-scale experiments with 22 representative waters (selected based on fluoride concentration, salinity, origin and in some instances organic matter) and 6 NF/RO membranes revealed that ionic strength and recovery affected fluoride retention and permeate flux. This is predominantly due to osmotic pressure and hence the variation of diffusion/convection contributes to fluoride transport. Different membranes had distinct fluoride removal capacities, showing different raw water concentration treatability limits regarding the WHO guideline compliance. BW30, BW30-LE and NF90 membranes had a feed concentration limit of 30-40 mg/L at 50% recovery. NOM retention was independent of water matrices but is governed predominantly by size exclusion. NOM was observed to have a positive impact on fluoride removal. Several mechanisms could contribute but further studies are required before a conclusion could be drawn. In summary, NF/RO membranes were proved to remove both fluoride and NOM reliably even from the most challenging Tanzanian waters, increasing the available drinking water sources.