Beta Thalassemia is the most common chronic hemolytic anemia in Egypt (85.1%).Iron overload remains the biggest threat to the health of patients with thalassemia. Multi-transfused thalassaemic patients may develop severe endocrine complications due to iron overload. Etiology of bone disease in thalassemic patients is poorly understood. Number of studies has examined the effect of various conditions on the pathogenesis of bone disease including ineffective erythropoiesis, iron overload, vitamin D concentrations, and the influence of endocrinopathies. Hypopara-thyroidism was found in 7.6% of a group of thalassemic patients in Iran but 3.6–7% reported in Italian thalassemic patients. The aim of this study is to determine the prevalence of low Bone mineral density in patients with B-thalassemia and to clarify possible etiology of bone disease in these patients, toassesparathyroid function, serum Ca, and vitamin D levels in thalassemic patients and its correlation to iron overload and to detect prevalence of osteoporosis in thalassemic patients.