Abstract Introduction: Due to iron overload, patients with beta-thalassemia may experience complications. Several adipokines have been proposed as potential contributors to the development of β-thalassemia complications. One of the adipokines, fatty acid-binding protein 4 (FABP4), connects various elements of the inflammatory and metabolic pathways. Aim of the study: This study assessed β-thalassemia patients' serum (FABP4) levels and linked them to complications related to thalassemia. Subjects and Methods: There were fifty adult participants in this cross-sectional study. A thorough clinical examination and medical history were completed. Every participant had their serum levels of fatty acid binding protein four measured. Results: According to our findings, 24% of patients had HCV+ve, 36% had gall bladder stones, and 44% had elevated liver enzymes. Patients with serum ferritin levels greater than 2500 ng/ml and FABP4 levels did not significantly correlate (p < 0.05). Conclusions: Patients with β-thalassemia had elevated liver enzymes, GB stones, and a high prevalence of HCV+. There was no discernible relationship between patients with serum ferritin levels higher than 2500 ng/mL and FABP4 levels.