It is well known that iodine and thyroid hormone are essential for normal development of the human brain and body. Lack of iodine in the diet leads to 'visible' and 'invisible' spectrum of iodine deficiency disorders. The prevalence of iodine deficiency can be assessed by estimating the total goitre rate in the population. A large section of the Indian population suffers from iodine deficiency disorders. These are easily preventable as was shown more than 40 years ago in the study conducted in Kangra Valley. Salt is the best medium of iodine supplementation in India. The potential risks of iodine supplementation, including the risk of iodine-induced thyrotoxicosis, are discussed. Finally, we attempt to formulate policy guidelines on iodine supplementation on the basis of presumed risk:benefit ratio for carrying out an iodine supplementation programme. Taking into consideration medical, social, economic and political aspects of universal salt iodization, the benefits far outweigh the potential low risk due to iodine excess in a small segment of the population.