Beta thalassemia is one of the most common single-gene disorders that require regular blood transfusion. Repeated blood transfusions in these patients lead to the accumulation of iron in the body that result in damage to critical organs such as liver, pancreas and heart. Diabetes is one of the most common endocrine disorder worldwide that due to high prevalence and chronic nature of diabetes imposes a heavy cost on health care systemTherefore this study aimed to assess prevalence of insulin resistance in beta thalassemia major. This study included 40 B-thalassemia major patients on regular blood transfusion ,age range 6-20 years and 40 control.Detailed history was taken about units of blood transfusion and chelation therapy.clinical examination included liver and spleen size. Laboratory investigations were done in the form of serum ferritin,fasting plasma insulin ,fasting and 2hrs post prandial plasma glucose.Insulin resistance was calculated using Homeostasis Model Assessment of insulin resistance (HOMA-IR) .Our results showed that 8% of thalassemic patients had insulin resistance.There was no statistical significance between insulin resistance, units of blood transfusion and serum ferritin.conclosion:insulin resistance is common in patients of beta thalassemia major and regular follow up of blood sugar is recommended.