Iodine deficiency disorders (IDD) are related to the degree of iodine deficiency. In European countries, characterized by mild to moderate iodine deficiency, neurological deficits or minor neuropsychological impairments have been described. Urinary iodine excretion (UIE) ranged from 30 to 170 mcg/L, 141 millions of people were at risk of IDD, 97 millions were affected by goiter and 0.9 millions had an impaired mental development. Iodine prophylaxis is devoid of adverse reactions with the exception of sporadic cases of transitory hyperthyroidism, associated to the severity of iodine deficiency before the prophylaxis. The International Council for Control of IDD recommends an universal iodine prophylaxis, instituted gradually in severe iodine deficient countries. The total cost of universal iodine prophylaxis is very cheap compared to the social cost of goiter and cretinism. In conclusion, most European countries are still characterized by mild to moderate iodine deficiency. Iodine prophylaxis programs are already operating, its cost is irrelevant with respect to the undebatable beneficial impact on the health. Adverse effects are not observed except in severe iodine deficient areas where iodine intake was abruptly increased.