Seven years of monitoring groundwater in the Gaza Strip has shown that nitrate was and still is a major groundwater pollutant. The objectives of this research were to study the distribution of NO(3)(-) in the groundwater of the Gaza Strip and to identify the sources of NO(3)(-) in the Gaza aquifer system by assessing nitrogen and oxygen isotopes. The most recent samples collected in 2007 showed 90% of the wells having NO(3)(-) concentrations that are several times higher than the WHO standards of 50 mg/L. Potential NO(3)(-) source materials in Gaza are animal manure N, synthetic NH(4) based fertilizers, and wastewater/sludge. The average concentrations of N in the sludge, manure and soil of Gaza were 2.9%, 1% and 0.08%, respectively. The range in delta(15)N of solid manure samples was +7.5 to +11.9 per thousand. The range in delta(15)N of sludge samples was +4.6 to +7.4 per thousand, while four brands of synthetic fertilizers commonly used in Gaza had delta(15)N ranging from +0.2 to +1.0 per thousand. Sludge amended soil had delta(15)N ranging from +2.0 to +7.3 per thousand. For both delta(18)O and delta(15)N, the ranges of groundwater NO(3)(-) were -0.1 to +9.3 per thousand and +3.2 to 12.8 per thousand, respectively. No significant bacterial denitrification is taking place in the Gaza Strip aquifer. Nitrate was predominantly derived from manure and, provided delta(15)N of sludge represents the maximum delta(15)N of human waste, to a lesser extent from septic effluents/sludge. Synthetic fertilizers were a minor source.