Iodine-131 (half-life = 8.04 d) is the most widely used radionuclide in medicine for therapeutic purposes. It is excreted by patients and is discharged directly to sewer systems. Despite considerable dilution in waste water and the relatively short half-life of I, it is readily measured in sewage. This work presents I concentrations in sewage sludge from three water pollution control plants (WPCPs) on Long Island, NY. Iodine-131 concentrations ranged from 0.027 ± 0.002 to 148 ± 4 Bq g dry weight. The highest concentrations were measured in the Stony Brook WPCP, a relatively small plant (average flow = 6.8 × 10 L d) serving a regional thyroid cancer treatment facility in Stony Brook, NY. Preliminary radiation dose calculations suggested further evaluation of dose to treatment plant workers in the Stony Brook WPCP based on the recommendations of the Interagency Steering Committee on Radiation Standards.