Marked changes in thyroid function occur during puberty as an adaptation to body and sexual development. Characteristics of thyroid growth were investigated in 259 healthy adolescents (110 girls and 149 boys), aged 11--17 yr, in an urban area of Switzerland with sufficient iodine supply. The thyroid volume determined by ultrasonography was correlated with chronological age, body weight, body height, cervical circumference, body mass index, and body surface area (BSA). Iodide concentration was measured in urine. The increase in thyroid volume mainly occurred between 11--15 yr (age at maximum thyroid growth rate, 12.5 yr) and was best correlated with BSA in both genders (girls, r(2) = 0.38; boys, r(2) = 0.49). The BSA-related thyroid growth was almost constant throughout puberty in boys and similar in girls up to menarche, but 14.5% larger in girls after menarche (P < 0.01). Percentiles of thyroid volume were lower than WHO reference values despite low normal urinary iodide concentration (median, 0.75 micromol/L). These findings suggest that physiological thyroid growth during puberty is mainly influenced by growth factors involved in somatic development and further modulated by sex steroid secretion profiles. The thyroid growth spurt coinciding with menarche in girls may contribute to a higher incidence of goiter during mid- to late puberty.