Although multiple authors have reported on various causes of external I-131 contamination after administration of radioiodine, to the authors' knowledge there have been no reported cases of external contamination from salivary secretions due to expectoration of chewing tobacco. A case of extensive I-131 contamination of a hospital room, furniture, and plumbing due to indiscriminate use of chewing tobacco during an inpatient I-131 radioablative therapy is presented.