Iron-aluminum-cerium hydroxide (Fe-Al-Ce), which has high fluoride (F) adsorption capacity, was granulated via extrusion with cross-linked poly (vinyl alcohol) (PVA) as the binder. The optimum granulation conditions for acquiring an adsorbent with a high F adsorption capacity and compression strength were: binder/Fe-Al-Ce powder ratio, 1.4; average cylinder diameter of granules, 1.6 mm; and drying temperature, 65 degrees C. The granulated Fe-Al-Ce (GFAC) exhibited a Langmuir maximum adsorption capacity of 51.3 mg g(-1) at pH 7.0 +/- 0.2. The GFAC in columns exhibited an accumulated F adsorption capacity of 5.7 mg g(-1) and 3.2 mg g(-1) at the breakthrough point (1.0 mg Fl(-1)) for treatment of F-spiked tap water (pH 7.8 +/- 0.2) and F-bearing groundwater (pH 8.2 +/- 0.2), respectively, which is several times higher than most reported F adsorbents under the same conditions. Energy dispersive X-ray micro analysis (EDX) showed that F was distributed evenly in the cross-section of the used GAFC, suggesting that most active sites inside the GFAC were available for F removal. A regeneration method using NaAlO2 solution to desorb F from the used GFAC was developed, permitting the GFAC to keep over 60% of its F adsorption capacity even after four adsorption-regeneration cycles. The results demonstrated that GFAC was superior in F adsorption performance to conventional adsorbents such as activated alumina. (c) 2012 Elsevier B.V. All rights reserved.