Introduction: Iron overload in beta-thalassemia leads to an enhanced generation of reactive oxygen species and to oxidative stress.Objective: This study was done to evaluate the oxidative stress and antioxidant status in Egyptian β-thalassemia patients through measuring serum Malondialdehyde (MDA) level (a product of lipid peroxidation) and measuring the blood level of vitamin E.Material and Methods: The present study was conducted on a group of Egyptian β-thalassemia patients (n = 32). They were divided into three groups according to the degree of severity and administration of chelation therapy. Group (1), nine patients of β-thalassemia intermedia without chelation therapy (non-chelated TI), group (2), twelve patients of β-thalassemia major without chelation therapy (non-chelated TM) and group (3), eleven patients of β-thalassemia major on chelation therapy (chelated TM). The patients were compared to a control group of healthy children of matching age and sex. Patients were subjected to full history taking, thorough clinical examination and general laboratory investigations (blood picture, lipid profile and liver function tests). Serum ferritin, MDA and vitamin E were also done.Results: The mean serum levels of ferritin were significantly higher in all β-thalassemia patients compared to controls (P < 0.01), with highest values observed in chelated and non-chelated TM patients when compared to TI (P < 0.01). The results were (1087 ± 299 ng/ml) in TI, (2157 ± 604) in non-chelated TM, (3182± 1515) in chelated TM, and (54 ± 41) in the control group. The mean serum levels of MDA which is the marker of oxidative stress was significantly higher among all β-thalassemia patients compared to controls (P < 0.01). The values were (3.77 ± 0.38 nmol/ml) in TI, (5.03 ± 0.49) in non-chelated TM, (4.89 ± 0.32) in chelated TM, and (2.71 ± 0.37) in controls. There were also significant higher levels of MDA among chelated and non-chelated TM groups compared to TI group (P < 0.01). The mean levels of serum vitamin E were significantly lower in all β-thalassemia patients compared to controls (P < 0.01). The values being (0.99 ± 0.18 mg/L) in TI, (2.75 ± 3.14) in non-chelated TM, (3.18 ± 3.33) in chelated TM patients, and (14.6 ± 3.28) in controls. Serum ferritin was positively correlated with the rate of blood transfusion (r = 0.801; P < 0.01). While, serum MDA was positively correlated with serum ferritin (r = 0.544; P < 0.01) and AST (r = 0.404; P < 0.05). MDA was also, negatively correlated with HDL-C (r = - 0.508; P < 0.01). Serum ferritin (r = 0.528; P < 0.01) and MDA (r = 0.605; P < 0.01) were positively correlated with the age of the patients. Serum vitamin E showed a significant positive correlation with serum levels of AST (r = 0.396; P < 0.05).Conclusion: The measurement of peroxidation product e.g. (MDA) in addition to evaluation of serum antioxidant e.g. (vitamin E) can be used as a simple measure of iron toxicity, in addition to the conventional indices of iron status.