Objective: To determine lipid profile abnormalities in ß -thalassemia patients with multiple blood transfusions in tertiary care hospital. Study design and setting: This cross-sectional study was conducted in Chemical Pathology section, Pathology department Sheikh Zayad Medical College and Hospital Rahim Yar Khan from 1st July 2022 to 31st October 2022. Methodology: 110 patients aged 1 to 18 years from both genders enrolled in Thalassemia center of Sheikh Zayed Hospital with multiple blood transfusions were included in study using convenient sampling technique. Patients with cardiac disease, diabetes mellitus and family history of lipid disorders were excluded. Blood samples collected from thalassemia patients were subjected to estimation of serum total cholesterol, serum triglycerides, HDL-C, and LDL-C. Data was recorded on predesigned performa. Post stratification t test was applied and p value <0.05 was considered significant. Results: Mean age of the patients was 7.77±3.846 years. Mean serum cholesterol, serum triglyceride, HDL-C and LDLC were 89.15±20.33mg/dl, 211.00±77.78mg/dl, 21.01±6.554mg/dl and 29.79±17.02 respectively. Mean triglyceride and LDL-C level was higher in patients with weekly transfusion than patients undergoing monthly transfusion with statistically significant difference of triglycerides and LDL-C between two groups with p=0.002 and 0.023 respectively. Conclusion: We found that frequent blood transfusion causes lipid profile abnormalities in thalassemia patients. Lipid profile abnormalities should be screened frequently in ß-thalassamia patients with multiple blood transfusions.