Iodine deficiency disorders (IDD) are pathological conditions associated with insufficient iodine intake in the body, leading to dysfunction of the thyroid gland. This article aims to analyze the current epidemiological situation of iodine deficiency disorders (IDD) and endemic goiter in different regions of the Republic of Uzbekistan, study etiopathogenetic factors influencing disease development, and evaluate the effectiveness of existing preventive measures. During the study, statistical data from the Ministry of Health of the Republic of Uzbekistan, WHO, and UNICEF for the last ten years, as well as comparative analyses of local and international scientific literature, were used. The level of iodine nutrition among the population was assessed using median urinary iodine concentration and thyroid ultrasound (US) findings. The analysis showed that the geographical location and biogeochemical characteristics of Uzbekistan contribute to the persistent high prevalence of iodine deficiency among the population. In particular, the prevalence of endemic goiter in the Fergana Valley and southern regions was reported to range between 40–60%. Pregnant women and school-aged children were identified as the most vulnerable groups, in whom median urinary iodine levels were found to be below international standards. Furthermore, the use of non-iodized salt in preventive measures and the influence of environmental “goitrogenic” factors were identified as major obstacles. It was concluded that salt iodization alone is not sufficient to eliminate iodine deficiency in Uzbekistan. In the future, mandatory fortification of flour and bread products, improvement of public health education, and systematic group prophylaxis using iodine preparations are considered key factors in preserving the national gene pool..