Frequent blood transfusion has increased the life expectancy of patients with β-thalassemia major, but it causes progressive iron overload causing important oxidative damage, mostly to the heart, liver and endocrine glands. This study aims at clinical evaluation of growth and puberty in multitransfused Egyptian β- thalassemia patients and its relation to their thyroid hormones levels, serum ferritin level and chelation therapy. This cross sectional analytical study included 30 thalassemia major patients, aged 13 to 24 years, 16 (53.3%) were males and 14 (46.7%) were females, 22 patients (73.3%) were short, all patients hadn't attained full puberty, 71.4% of the girls >16years had primary amenorrhea, 63.3% of all patients had high TSH levels, 47.4% of them had low FT4 levels (clinical hypothyroidism) and the remaining patients(52.6%) had normal levels of FT4 (subclinical hypothyroidism). There were statistically signifiant inverse correlations between SD height and both serum ferritin and TSH (r= -0.90 & - 0.906) and between Tanner score & both serm ferritin and TSH (r= -0.04 & -0.09) respectively. In this study, short stature, hypogonadism and hypothyroidism were frequent findings. These results support the need for vigilant clinical evaluation of growth and puberty, as well as appropriate hormonal evaluation in multitransfused thalassemic patients in order to detect and treat endocrine dysfunction early. It is also recommended to start aggressive and adequate chelation from early life so that permanent damage to the endocrine glands can be prevented.