Background: Renal disorders are not rare in patients with β-thalassemia. Functional and physiological abnormalities can be detected in both thalassemia major and thalassemia intermedia patients. We aimed to evaluate the renal manifestations in 123 pediatric patients, 91 (74%) TM and 32 (26%) TI.Methods: All patients were subjected to full history, clinical examination, and laboratory tests including, kidney functions with calculation of Glomerular Filtration Rate according to Schwartz Formula, serum electrolytes, serum uric acid, complete urine analysis, albumin and creatinine in urine with calculation of the albumin/creatinine ratio. Plain KUB and abdominal ultrasonography were done for all patients.Results: BUN, serum creatinine, serum potassium and GFR were within range and were comparable in both groups (p>0.05). Serum uric acid was increased in most of te studied cases. Patients with low GFR showed a high serum uric acid levels. Serum sodium was higher in TI (p<0.05). Eighty-three (67.5%) patients had albuminuria. Mean urinary proteins and mean urinary creatinine were higher among TM patients but difference was not significant (p>0.05). One hundred and forteen (93%) patients had preclinical increase in A/C ratio and 9 (7%) had a clinical rise. The prevalence of high A/C ratio was nearly similar in both groups (p>0.05). Fifty-eight (89%) patients on deferiprone had preclinical elevated levels of A/C ratio, while all on DFO had preclinical elevated A/C ratio (p>0.05). One case had renal stones and one had renal cysts.Conclusion: Renal affection is not uncommon in -thalassemia. Screening by GFR, A/C ratio and uric acid is recommended in these patients.