A patient with bilateral, insidiously developing enlargement of the parotid glands that started 1 year after a total thyroidectomy and ablative radioiodine therapy (200 mCi I131) for papillary carcinoma is presented. The patient displayed prolonged periods of hypothyroidism accompanied by hypercholesterolinemia, notwithstanding hormone replacement therapy. Three years after surgery, parotid and lacrimal gland functions were reduced and fatty degeneration of the parotid parenchyma was demonstrated histologically. The submandibular and sublingual glands were preserved. It is suggested that the hormonal and metabolic derangements are responsible for the glandular dysfunction, rather than a direct effect of iodine on the glands.