Iodine deficiency disorders (IDD) result from inadequate thyroid hormone production due to inadequate iodine intake. It is estimated that 2 billion individuals worldwide have insufficient iodine intake. Iodine deficiency is the most common cause of preventable mental impairment worldwide. The usually recommended strategy to control iodine deficiency is through universal salt iodization and more recently through iodine fortification of flour. Introduction of iodized salt to regions of chronic iodine-deficiency disorders might transiently increase the proportion of thyroid disorders due to iodine excess, but overall the small risks of iodine excess are far outweighed by the substantial risks of iodine deficiency. Food authorities in different countries should be empowered to implement suitable protocols and ensure that effective follow-up procedures are in place, such as those used by the Food Standards in Australia and New Zealand. Future aspects and recommendations are also highlighted in this review.