Standard of care for thalassemic patients have improved in recent years, resulting in almost doubling of the average life expectancy. As a consequence, additional previously unscribed complications are new being recognized.In particular, profound hemostatic changes have been observed in patients with thalassemia major or thalassemia intermedia. These hemostatic changes may be in the form of thrombotic or hemorrhagic events. To study hemorrhagic events we assessed platelet aggregation to ADP and Ristocetin in thalassemic children presenting with epistaxis and compare the results to group of normal children in the same age a sex group presented to E.N.T. clinic by recurrent epistaxis. Control group had no bleeding tendency due to haematological condition.Both cases and control were subjected to complete clinical examination, Full Blood Count (FBC.), liver enzymes (AST, ALT), PC,PT,PTT and serum ferritin. In addition, platelet aggregation to ADP and ristocetin were assessed for both cases and control too. The levels of plalelet aggregation to ADP and ristoctein found to be statistically lower in thalassemic children as compared to control.The results were positively correlated with ALT, which indicate that liver status is contributing factor in bleeding tendency in thalassemic cases. In conclusion, bleeding tendency in thalassemic patients can be attributed to a defect in platelet aggregation namely platelet hypoaggregation. However, hepatic dysfunction associated with the disease can be a contributing factor as well.Thalassemic children with bleeding tendency should receive vitamin K supplementation to compensate for hepatic synthesis defect. On the other hand to study hypercoagulable status we assessed CD62p as a marker of in vivo platelet activation which in turn indicate hypercoagulability state in thalassemic children. To compare the results with normal children attending out patient clinic of new children hospital, Cairo University both cases and control were subjected to complete clinical examination, Full Blood Count (FBC), liver enzymes (AST,ALT), PC, PT, PTT. And flow cytometric study for CD62P as a marker of in vivo platelet activation were assessed for both cases and control.Patients result found to be statistically insignificant as compared to control. In spite of that detection of membrane P-selectin by flow cytometry is accepted as a sensitive marker of platelet activation, it is not specific for platelets. So, CD62p can not be considered as a reliable marker for assessing platelet activation due to many complexities associated with its estimation.