Across the United States, rural residents rely on unregulated and generally unmonitored private wells for drinking water, which may pose serious health risks due to unrecognized contaminants. We assessed the nature, degree, and spatial distribution of cumulative health risks from inorganic contaminants in groundwater. Our analysis included nearly 84,000 data points from 6500+ wells, across 51 of Montana's 98 watersheds, using a public groundwater database. We compared a drinking water screening level cumulative risk assessment (CRA) for inorganics based on the U.S. Environmental Protection Agency (EPA) protective health thresholds (Maximum Contaminant Level Goals, Health Advisories [MCLG-HAs]) to a CRA based on EPA public supply enforceable Maximum Contaminant Levels (MCLs). Based on median concentrations of 19 inorganics (antimony, arsenic, barium, beryllium, boron, cadmium, chromium, copper, fluoride, manganese, molybdenum, nickel, nitrate, lead, selenium, strontium, thallium, uranium, zinc), 75% of watersheds had MCLG-HA-based cumulative risk values > 1.0; arsenic and uranium contributed the most risk, followed by strontium, fluoride, manganese and boron. Hence, this screening level (Tier I) CRA indicated widespread potential for unrecognized human health risk to private well users from inorganic contaminants considering both carcinogenic and non-carcinogenic risks. Sensitivity analysis showed that benchmarks applied (MCLG-HAs versus MCLs) exerted the largest control on results. Our findings identify priority regions for Tier 2 risk assessments to elucidate local sources and distributions of geogenic versus anthropomorphic contaminants. Our study is the first statewide assessment of cumulative health risk from groundwater that we are aware of, and results support increased statewide drinking water education and testing to reduce human health risks from contaminated private well water.