Background: Regular blood transfusion in children with beta thalassemia major lead toperoxidative tissue injury secondary to iron overload, increased oxidative stress and disturbance of oxidant anti-oxidantstatus of patients. Aim of Study: The present study aimed to assessoxidative stress, trace elements and oxidant-antioxidants status of beta thalassemia-major (b-TM) patients on regular blood trans-fusion. Patients and Methods: A case-control study included 35 beta thalassemic patients attending the pediatric Haematolo-gyclinic of El-Galaa Teaching Hospital and 35 age sex healthy matched subjects as control group. Serumzinc (Zn), copper (Cu), magnesium (Mg), serum Malondialdehyde (MDA), Superoxide Dismutase (SOD), serum catalase (CAT), Total Antioxidant Capacity (TAC) were performed for both patients and control. Results: Meanserum iron, ferritin, Alanine Transaminase (ALT), Aspartate Transaminase (AST) and total bilirubin levels were significantly higher in the b-TM group while mean hemoglobin, hematocritand total iron binding capacity were lower in the b-TM group. A significant increase in the levels of MDA, SOD whereas significant decrease in the levels of serum Zn, Mg. TAC and CAT was observed in the b-TM group. No significant difference in serum Cu between patients and control. Serum ferritin was found to have positive correlation with patients' age, weight, height, ALT, AST and total bilirubin, MDA, serum iron while significant negative correlation with total iron binding capacity, serum Zn and Mg levels whereas no significant correlation with serum Cu, SOD, CAT, TAC. Conclusion: Childrenwith beta thalassemia major suffering from oxidative stress, deficiency of some micronutrients and endogenous antioxidants. Selected trace elements and antioxi-dants supplementation require further studies for their eva-luation.