Iodine deficiency is considered to be one of the most common nutrition disorders in the world and the world's greatest single cause of preventable brain damage. Despite a worldwide application of successful iodine supplementation programs over the last four decades, iodine deficiency remains a major public health problem throughout the world. All European countries except Iceland have experienced this health and socioeconomic threat to a greater or lesser extent. The fact that mild to severe iodine deficiency persists in many European countries may have important public health consequences, including impaired intellectual development of infants and children. Iceland has in the past been known for its high iodine status, based on results from studies of iodine status from 1939, 1988, and 1998 suggested to be due to high fish consumption. Fish together with milk and other dairy products are the main sources of iodine in the Icelandic diet, but iodized salt is not commonly used. In recent years fish and dairy intake has decreased, especially among young people. In this paper, historical data on iodine status and iodine intake in Iceland is reviewed and the need for further studies as well as possible need for public health actions evaluated.