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Background: Iodine supplementation with salt as a carrier was introduced in Sri Lanka in 1995. Literature from elsewhere suggest that there is an increase in hyperthyroidism after the initiation of such programmes. Objectives: To identify weather iodination precipitated an exacerbation of hyperthyroidism in the Central Province of Sri Lanka Methods: Four-hundred-and-eight consecutive patients with hyperthyroidism seen over a period of thirty one years in a General Surgical Clinic at Teaching Hospital, Peradeniya were reviewed. Results: The prevalence of secondary hyperthyroidism increased after iodination. No change in the demography and presentation of simple diffuse toxic goiter was observed. Conclusions: Physicians must be aware of this increased incidence of hyperthyroidism after iodination and need to be vigilant of the need to control it, in view of its complications.