Repeated blood transfusions in thalassemia patients is followed by endocrinopathies as diabetes, hypothyroidism, hypogonadism, hypoparathyroidism, and disorders in calcium and vitamin D homeostasis. The aimof this study was to evaluate the association of beta-thalassemia patientsendocrinopathies and osteoporosis. Serum level of some factors related tothe function of gonads, thyroid, adrenal, and pancreas along with serumlevels of calcium, phosphate, albumin, vitamin D, and iron were measured.Bone marrow density was tested via dual-energy x-ray absorptiometry(DXA densitometry). In this study, 56 patients with major thalassemia wereinvestigated. Paraclinical analysis indicated osteopenia in 17 (30.4%) andosteoporosis in 39 patients (69.6%) in addition to other types of endocrinedisorders, such as hypogonadism in 29 (51.8%), hypothyroidism in 13(23.2%), hypoparathyroidism in 1 (1.8%), hypocortisolism in 2 (3.6%), anddiabetes in 9 (16.1%) patients. Endocrinopathies had no significant relationship with osteoporosis and osteopenia in men. However, hypogonadismhad a significant relationship with osteoporosis and osteopenia in womenwith thalassemia. Estradiol level was lower in women with osteoporosisin comparison with women with osteopenia. Ferritin levels had neitherassociation with osteoporosis nor with LH levels (P>0.05). Secondary hypogonadism disorders are the main causes of osteoporosis and osteopeniain female beta-thalassemia patients.