Abstract：The distribution of endemic diseases has a close relationship with various geological environments such as topography and relief, geological structure, strata and lithology, soils, and hydrogeological conditions. Based on the data obtained from endemic investigation and eco-geochemical investigation in the lower Yellow River basin of Shandong Province, the authors studied the relationship between the endemic goiter induced by excessive iodine and the geological environment in the aspects of relief, soils and potable water. The results suggest that endemic goiter has high positive correlation with iodine content in water but has no correlation with iodine content in soils. In view of preventing and treating endemic goiter, the authors put forward some suggestions concerning the prevention of endemic goiter and the improvement of the environmental geological situation.