The relationship between fluorosis and the lifestyle of adult residents of areas in which fluorosis is endemic was evaluated. A cross-sectional and case-control analysis was performed to study 289 villagers living in fluorosis endemic areas who drank the local water. Subjects were divided into skeletal fluorosis and non-skeletal fluorosis groups according to whether they were afflicted with skeletal fluorosis. A semi-quantitative food frequency questionnaire, homemade lifestyle questionnaires, and general characteristics were analyzed. The factors that affected the occurrence of skeletal fluorosis were determined by generalized estimating equations. Our results showed that protective factors against skeletal fluorosis included drinking boiled water, storing water in a ceramic tank, and ingesting fruits, vitamin A, thiamine, and folic acid. Risk factors for skeletal fluorosis were overweight status and obesity, drinking tea, drinking water without storage, and ingestion of oils, fats, and phosphorus. Our results demonstrate that skeletal fluorosis has a close relationship with lifestyle.