The analysis of existing in different countries of the world approaches to the management of liquid radioactive waste (LRW) of patients generated during radionuclide therapy with 131I is carried out. The regulated values are given, on the basis of which criteria for the discharge of LRW containing 131I into a centralized urban sewage system are established for medical organizations in a number of countries. The most common strategies for the management of patients’ LRW after radiotherapy are considered. Compliance with the discharge criteria may be achieved by delaying radioactive effluents for decay in specially designed delay tanks or by its dilution with inactive effluents of a medical organization at the discharge point. The chosen strategy should be determined by the parameters characterizing the discharges of a particular organization, so as not to affect the capacity of the department and, as a result, the availability of the radiotherapy procedure to patients in the country. Defining a case-by-case treatment strategy or using the two strategies considered in combination with each other may be a more effective practice for treating patients with LRW. The latter may be relevant for medical organizations in Russia, where the discharge criteria is conservative, and at the legal level it is prohibited to use another strategy for handling LRW, except for storage for decay.