The KCNQ1 α subunit and the KCNE2 β subunit form a potassium channel in thyroid epithelial cells. Genetic disruption of KCNQ1-KCNE2 causes hypothyroidism in mice, resulting in cardiac hypertrophy, dwarfism, alopecia, and prenatal mortality. Here, we investigated the mechanistic requirement for KCNQ1-KCNE2 in thyroid hormone biosynthesis, utilizing whole-animal dynamic positron emission tomography. The KCNQ1-specific antagonist (−)-[3R, 4S]-chromanol 293B (C293B) significantly impaired thyroid cell I− uptake, which is mediated by the Na+/I− symporter (NIS), in vivo (dSUV/dt: vehicle, 0.028±0.004 min− 1; 10 mg/kg C293B, 0.009±0.006 min− 1) and in vitro (EC 50: 99±10 μM C293B). Na+-dependent nicotinate uptake by SMCT, however, was unaffected. Kcne2 deletion did not alter the balance of free vs. thyroglobulin-bound I− in the thyroid (distinguished using ClO 4−, a competitive inhibitor of NIS), indicating that KCNQ1-KCNE2 is not required for Duox/TPO-mediated I− organification. However, Kcne2 deletion doubled the rate of free I− efflux from the thyroid following ClO 4− injection, a NIS-independent process. Thus, KCNQ1-KCNE2 is necessary for adequate thyroid cell I− uptake, the most likely explanation being that it is prerequisite for adequate NIS activity.—Purtell, K., Paroder-Belenitsky, M., Reyna-Neyra, A., Nicola, JP, Koba, W., Fine, E., Carrasco, N., Abbott, GW The KCNQ1-KCNE2 K+ channel is required for adequate thyroid I− uptake.