Pharmaceutical sodium salts are prone to incorporate water into their crystal structure. The model compound diatrizoic acid monosodium salt, an X-ray contrast agent, has been investigated in depth towards its interaction with water in the solid state. Five hydrates with water content ranging from 0.3 to 8 molar equivalents of water show a high degree of interconvertibility, stoichiometric and non-stoichiometric behaviour, and potential of amorphisation during release of water. A DMSO/water mixed solvate further highlights the high attraction of this salt to incorporate water. All incorporated solvent coordinates to the sodium cation and can further interact and stabilise the respective crystal forms by hydrogen bonding. DTS thus highlights the importance of an in-depth investigation of sodium salts used pharmaceutically to guarantee dose uniformity and stability of final formulation.