Thalassemia is a major health concern in Egypt, the carrier rate of β-thalassemia (TM) is about 10%. Hypertransfusion therapy has strikingly increased the survival in patients with β-thalassemia over the past decade, at the same time it has increased the risk of complications caused by iron overload. The present study" was designed to assess the derangements in carbohydrate metabolism in transfusion dependant β-thalassemic children; where Glyco-metabolic status was evaluated in 50 transfusion dependent β-thalassemic patients; age ranging from 7 to 17 years, and in 28 age-matched healthy subjects using an oral glucose tolerance test (OGTT). The results showed that 52% of the included patients had short stature, while 10 % suffered from impairment of glucose tolerance. The age of start of blood transfusion was found significantly lower in TM patients with IGT (1.3±0.9) compared to TM patients with NGT (2.7±1.6) with a P-value of (0.00); suggesting that it is one of the risk factors associated with abnormal glucose tolerance. Blood glucose levels at (0, 60, 90, 120 minuets) were found significantly higher in thalassemic patients than in controls. Serum ferritin had a significant positive correlation with blood glucose levels at 30 and 60 minuets. Serum ferritin also had a highly significant positive correlation with AST. In conclusion; although the prevalence of IGT in our study was not so high (10%), yet it is one of the most serious endocrinal complications in mulitransfused thalassemic patients. So, it is strongly recommended that OGTT should be done as early as the thalassemic child approaches puberty for the early diagnosis of glucose intolerance.