To address the growing volume of iodine-containing radioactive wastewater generated from the use of 131I therapy and limited capacity of decay pools, it is essential to identify an efficient disposal method. This study investigates the treatment of 131I radioactive wastewater using a macroporous strong base anion-exchange resin (D201). A series of batch adsorption experiments were conducted to assess the impact of various factors on the adsorption process, including contact time (0-8 h), temperature (25℃-55℃), pH (3–11), initial iodine concentration (0-3000 mg/L), and presence of competing anions. The results indicate that at a temperature of 25 °C and pH = 7, the adsorption effect of D201 is optimal; the adsorption can reach equilibrium within 2 h; when the initial iodine concentration is 2500 mg/L, the maximum saturated adsorption capacity of the resin can reach 158.02 mg/mL. The adsorption process conforms to the pseudo-second-order kinetic model and the Langmuir isothermal model. Additionally, the resin exhibited a strong preferential selectivity for I−, achieving a removal efficiency of up to 99% in column experiments.