Iodine is an essential dietary element required for normal fetal growth and development. We aimed to explore intraindividual and interindividual variations in iodine intake in pregnant women and whether non-dietary factors might influence the intake. Iodine intake was assessed in 271 women, residing in Matlab, rural Bangladesh, by measuring their urinary iodine concentration (UIC) at gestational week (GW) 8, 14, 19, and 30 with inductively coupled plasma mass spectrometry. The women's UIC increased significantly during pregnancy (median 241 (GW8) and 300 μg/l (GW30)). About 6% of the women had insufficient iodine intake (UIC<150 μg/l) and 10% had excessive iodine intake (UIC≥500 μg/l) at all of their four sampling occasions. The women's UIC were dependent on their education, socio-economic status, and BMI, as well as the season of sampling and iodine concentrations in drinking water. Supplementation with a multi-micronutrient capsule, including 150 μg potassium iodine, increased the UIC in women with the lowest UIC (10th percentile) at GW30 but decreased the UIC in women with the highest UIC (90th percentile) at GW30. In conclusion, median UIC throughout pregnancy indicated adequate intake of iodine among pregnant women in Matlab, but, notably, consistently insufficient and excessive intake was also prevalent.