Endemic goiter is a complex thyroid condition that progresses through different stages. The study classified it into Stage 1 (overgrowth), Stage 2 (enlargement), and Stage 3 (nodule formation). As the disease advances, symptoms worsen, but overall health remains normal without complications. Women are more affected than men, with peak occurrence in their 20s to 30s for women and 30s to 40s for men. Surgery is more common in adults, especially women, with iodine treatment being more effective in younger patients. Stage 3 cases may have complications like hyperthyroidism, adenoma, or thyroid cancer. Iodine treatment is effective in Stage 1 but ineffective in Stage 2, where surgery is recommended.