Abstract: Differentiated thyroid carcinoma (DTC) includes papillary thyroid carcinoma and follicular thyroid carcinoma, and ¹³¹I therapy serves as the cornerstone of postoperative management for DTC. Excellent response (ER) is a key indicator for evaluating the therapeutic response of DTC, which indicates no recurrence or residual disease in patients, and exhibits a favorable prognosis. However, substantial interindividual variability exists in patients' responses to ¹³¹I therapy: some patients fail to achieve ER, and a subset even progress to radioactive iodine-refractory DTC. Identifying the key factors influencing ER is critical for optimizing individualized treatment strategies. Therefore, the authors systematically review recent research on the predictive factors associated with ER attainment in DTC patients following ¹³¹I therapy, covering thyroglobulin and its related indicators, tumor clinicopathological features, treatment protocols, comorbidities, and other relevant factors, so as to provide a theoretical basis for precise clinical management.