Background: Thalassemia is a major inherited public health problem in the Mediterranean area. Aim of this study was to assess children knowledge about thalassemia and iron chelation therapy. Subjects and methods: A descriptive research design was used. A convenient sample was used; it includes 50 thalassemic children on chelation therapy, and their family caregiver.. This study conducted at the pediatrics outpatient department at the Health Insurance Agency Hospital in Damietta city. Tools Two tools used for data collection. An interview questionnaire form to collect data about socio-demographic characteristics for studied children and their caregivers, assessment of knowledge  related thalassemia and iron chelation therapy  sheet. Results: revealed that, only 26% of children had satisfactory knowledge related thalassemia, and only 12.0% , 26% of the studied children had total satisfactory knowledge related to management of thalassemia and desferal respectively. Conclusion, the study concluded that there is an improvement in the children's knowledge. The study recommended developing frequent educational training programs for children with thalassemia  about chelation therapy through updated posters, booklets and  brochures and a repeat of this research on a large sample and in various places in Egypt for improving children's knowledge and practice