Epidemiological surveys on goiter endemia carried out in Italy in the two last decades were recently reviewed. Iodine deficiency and endemic goiter were documented in the entire country. In recent studies, urinary iodine excretion was higher and prevalence of goiter was lower than that documented in the past, in absence of a national program of prophylaxis. Nevertheless, in a recent study carried out in Basilicata, in schoolchildren a goiter prevalence of 16% was documented. In conclusion, iodine deficiency and endemic goiter are still present in Italy; despite the beneficial effects of "silent prophylaxis", a iodine prophylaxis program is mandatory.