The nose has been reported as a site of radioiodine accumulation on 131I whole-body scintigraphy. To determine the frequency, intensity, and pattern of nasal radioiodine accumulation, a prospective study was performed on 21 patients referred for 131I whole-body scintigraphy during a 26-mo interval. All patients were dosed with 5 mCi (18.5 MBq) of 131I p.o., and imaged 72 hr later. Ninety-five percent (20/21) of patients had nasal radioactivity greater than background, and in 75% (15/20) of positive patients the pattern of activity was round. Clinical follow-up of these patients has shown no evidence of tumor involvement in the nasal area. We conclude that nasal radioiodine activity is a normal finding. Radioiodine uptake in the nasal area, without clinical suspicion of metastatic disease, should not be considered a criterion for surgical intervention or radioiodine therapy.