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Introduction: Endemic goiter due to iodine deficiency is one of the health problems in the developing countries. Material & Methods: In this cross-sectional study, 109 schoolboys and 92 schoolgirls, aged between 6 and 18 years in Rafsanjan city were selected randomly by proportionate-multistage cluster sampling method. All the students underwent clinical examination for presence of goiter according to criteria recommended by WHO, and urinary iodine excretion, T4, FTI and TSH were measured. Results: The point Prevalence rate of goiter in boys and girls were 71.6% and 55.6%, respectively. Prevalence rates of Grade I and II were 51.3% and 12.9%, respectively. Urinary iodine excretion was normal in 68.1% (>10 μg/dl) mild in 30.6% (5-9.9 μg/dl) and moderate in 1.3% (2.1-4.9 μg/dl). Of 68.1% of schoolchildren with normal urinary iodine, 56.9% showed different grades of goiter. There was no relation between goiter stages and urinary iodine deficiency (P>0.05). T4, FTI and TSH in 96% of schoolchildren were normal. In 3%, TSH levels were more than the normal range (>3.5 μU/ml) and in 1%, T4 concentration was less than the normal range (<60 nmol/L). There was a meaningful statistical relationship between TSH concentration and goiter grades (P=0.044),. There were no significant relation between T4, FTI and different grades of goiter (P>0.05). Conclusion: With respect to the fact that urinary iodine levels were normal in 68.1% of the students and thyroid parameters were normal in 94% of the subjects, the very high prevalence rate of goiter in the city of Rafsanjan seems to be due to certain unknown etiological factors which needs further studies

Keywords: Goiter, Disturbance due to iodine deficiency, Goitrogen, T4, TSH, FTI, Rafsanjan.

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