The etiology and pathogenesis of Kashin-Beck disease (KBD) remain uncertain at present. A deficiency of selenium and iodine is considered common in KBD-affected areas. Supplying selenium and iodine for the prevention of KBD has been performed in the past few decades in affected areas in China. Supplying selenium and/or iodine has produced positive http://www.iciba.com/different/effects in most KBD-affected areas, but there are some affected areas where the effects have been unclear and supplementation with selenium and/or iodine has not eliminated this disease. From animal and vitro experiments, we explore whether a deficiency of selenium and/or iodine may be the environmental factor causing KBD. KBD may have multiple etiologies. The role of selenium and iodine in KBD mainly involves antioxidation and maintenance of thyroid function according to the present review. Other important roles of selenium and iodine in KBD and a certain etiology of this disease need further study.