Background: Beta thalassemia is a disorder of hemoglobin leading to hemolytic anemia, ineffective erythropoiesis and iron overload that mediates much of the morbidity and mortality of the disease. Hepcidin is a peptide hormone that plays a crucial role in iron homeostasis. Objectives: Here we assessed the value of serum hepcidin level as a marker of iron overload in thalassemia patients. Patients and Methods: This case control study involved 30 thalassemia patients and 10 controls. The patients were selected from the Hematology Department of Ain Shams University Hospitals. We assessed the value of serum hepcidin level and see how it is correlated to values of serum ferritin along with MRI T2*on the liver and the heart in the same patients. Results: The median hepcidin level for cases was significantly lower than that for controls with P value (0.004), but serum hepcidin was not a statistically significant marker of iron overload when correlated with either serum ferritin or hepatic and/or cardiac MRI T2* findings of the patients. However, we found a significant correlation between hepcidin and gender, blood transfusion frequency and hepatitis C infection. Conclusion: hepcidin is not directly correlated to markers of iron overload in thalassemia patients. In these patients with anemia and iron overload, the erythropoietic drive is the dominant factor influencing hepcidin levels. Therefore, hepcidin is not a good marker of iron overload, but rather a good marker of erythropoietic drive.