The aims of this study were to investigate and confirm the occurrence and distribution patterns of iodinated X-ray contrast media (iopromide) in Nakdong river basin (mainstream and its tributaries). Iopromide was detected in 16 sampling sites. The concentration levels of iopromide on February 2011 and on October 2011 in surface water samples ranged from not detected (ND) to 1481.1 ng/L and ND to 1168.2 ng/L, respectively. The highest concentration level of iopromide in the mainstream and tributaries in Nakdong river were Goryeong and Jincheon-cheon, respectively. The sewage treatment plants (STPs) along the river affect the iopromide levels in river and the iopromide levels decreased with downstream because of dilution effects.