In order to reevaluate effectiveness of iodine prophylaxis in Macedonia, epidemiological, ultrasonographic studies and estimation of urine excretion were performed. The results from the epidemiological survey in nongoitrogenic regions demonstrated goiter between 12.8% and 18%. Much higher prevalence of goiter was found in goitrogenic regions, between 20.8% and 60.8%. The incidence of goiter increased with age, and its prevalence is higher in girls when compared with the boys of the same age group. The thyroid volume estimated by ultrasonography was higher in children from goitrogenic regions when compared to nongoitrogenic. There was a good correlation between ultrasonographic volumetry data and size of the thyroid estimated by palpation. Urinary iodine excretion demonstrated low values in children from goitrogenic regions as indicator of iodine deficiency.