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Presence of fluoride and pathogen in drinking water is an issue of concern due to their health effects and as such much effort is being directed towards finding sustainable material for use in water treatment. Adsorption based water treatment techniques are often considered as the most effective and easy to use in rural set up. However, most of the adsorbents are not multifunction and are only effective towards fluoride. In this study aluminosilicate activated clay was hydrothermally treated and applied for fluoride and pathogen removal from water. Fourier transform infrared (FTIR), Brunauer-Emmett-Teller method (BET), X-ray diffraction spectroscopy (XRD) and Scanning electron microscopy-energy dispersion spectroscopy (SEM-EDS) techniques were employed to characterize hydrothermally treated aluminosilicate clay (HTAC). Batch defluoridation experiments were used to evaluate the fluoride removal efficiency while well diffusion assay method was used to evaluate the antimicrobial efficiency. The BET results showed increase in surface area from 17.19 m2/g to 33.56 m2/g after treatment. Batch defluoridation showed maximum adsorption capacity of 1.75 mg/g with 53% fluoride removal from initial fluoride concentration of 6 mg/L using 0.8 g/40 mL dosage at initial pH 5.8 and contact time of 5 min at room temperature. The adsorption kinetics data showed a better fit to pseudo-second order model while the adsorption isotherm data showed correlation coefficient and chi-square values of 0.98 and 0.01, respectively indicating a better fit to both Langmuir and Freundlich adsorption isotherms. The regeneration studies showed that the material can be reused for up to six times using 0.1 M KCl as regenerant. Antimicrobial studies showed that HTAC has potency against Escherichia coli (E. coli) strains. The study showed that synthesized HTAC has strong potential for application in fluoride and pathogen removal.