The purpose of this study was to evaluate the side-effects of differentiated thyroid carcinoma after treatment with 3.7-7.4 GBq of 131I. A total of 342 patients were treated with 131I from May, 1989 to January, 1999. The acute side-effects, the short-term and long-term side-effects were analyzed. The follow-up lasted 1-10 years with an average of 5.4 years. The results showed that thyroiditis occurred predominantly in the patients with a rate of 131I uptake > 30%, whereas sialoadenitis occurred more prevalently in the patients with a rate of 131I uptake < 30% (P < 0.001). The rates of nausea, vomiting, diarrhea and gastralgia were 12.2%, 5.2%, 3.5% and 2.7% respectively. There were no significant changes in the hemogram after treatment, compared against that before treatment. The overall rates of transient platelet abnormalities and leukopenia were 10.4% and 4.0% respectively, but the rates of the abnormalities in the patients with cumulative doses of 131I > 18.5 GBq were significantly higher than those in patients with cumulative doses of 131 I < 18.5 GBq. The lower rate of acute and short-term side-effects and the absence of long-term side-effects in this study indicate that 131I can be safely used to treat differentiated thyroid carcinoma.