After the first examinations made in 1960-1972 the endemic area of the Saratov region was re-examined in order to study over time the children's health status, to estimate the tension of goiter endemic and the biogeochemical characteristics of the area. Relative iodine deficiency and unbalance of trace elements in the environment were ascertained. Considerable prevalence of thyroid hyperplasia, stages I-II, II (50.7%) was established among the child population with practically equal distributions among girls (5376%) and boys (46.4%). During the 20-year period, the number of children with the enlarged thyroid was found to be 1.5-fold as increased. According to the data on the hormonal profile, 23.3% of the children manifested the dissociation of the content of T3 and T4 in the blood serum, whereas 88% of the children had a high level of TSH. In addition to the thyroid pathology, carious disease, chronic diseases of the nasopharynx, anemias and posture impairment occurred most often. Only 10.7% of the children can be regarded as practically healthy. The significance of the familial and hereditary preparedness for the onset of endemic goiter has been confirmed.