Background: Thalassemia, an inherited blood disorder, is a global health concern. Β-thalassemia major leads to impaired erythropoiesis and increased hemolysis. Blood transfusions can cause iron overload and endocrine complications, including hypoparathyroidism. Understanding hypocalcaemia mechanisms is crucial for effective treatment and prevention. Aim: This study aimed to evaluate subclinical hypoparathyroidism and hypocalcaemia among patients with transfusion-dependent beta thalassemia major for early diagnosis and management. Patients and methods: Each participant's informed consent was obtained before using a structured interview-based questionnaire included individual sociodemographic details, comorbid chronic diseases make up the second section, the patient's current drugs, and the surgical procedures like splenectomy and thyroidectomy, and laboratory investigations.  Results:  The study involved 73 thalassemic patients, with a mean age of 26.2 years, 54.5% females, and 35.5% males. Majority of hypocalcaemia cases were asymptomatic, and the prevalence of hypoparathyroidism was 24.7%. Patients with hypoparathyroidism had higher levels of PTH and total & ionized calcium, while ferritin concentration was higher. Advanced age, treatment compliance, and ferritin were significant risk factors. Conclusion: Individuals with transfusion-dependent thalassaemia frequently experience hypoparathyroidism and hypocalcaemia, which may be brought on by inadequate chelation. In individuals with iron excess, hypocalcaemia is often asymptomatic and persistent.