Endemic goitre was prevalent in the population of Derbyshire in the UK for many centuries until it declined from the 1930s. A contemporary medical survey showed that endemicity of goitre was particularly higher in the Carboniferous limestone areas of the Derbyshire-Peak District. Unlike classical goitrous areas of the world, where the distribution of goitre has been found to be related to the iodine content in the environment, there is no such relationship reported for the Derbyshire-Peak District area. The present study reviews the presence of endemic goitre in this area with reference to iodine in different environmental media using past and present data. In comparison with the world average values, the iodine contents in the soil and sediment in the Peak District are not deficient, but compared to England, Wales and Scotland averages, these levels are low. As no information on the mobility and bioavailability of iodine of this area is available, a cautious approach is necessary before any assumption is made on the aetiology of endemic goitre. The study also discusses some hypotheses relating to the possible cause of endemic goitre in the limestone areas. Further research needs are suggested depending on the land use and geochemistry of the Peak District to determine the underlying causes of the former endemic goitre in this area.