β – thalassemia major is a chronic inherited blood disorder requiring lifelong treatment including blood transfusion, putting tremendous burden on caregivers of the affected children. Aims were to measure the burden of care, prevalence and severity of depression and anxiety, and their association with various socio-demographic and illness related factors in caregivers of children with β – thalassemia major. A cross-sectional study was conducted on 100 caregivers of children suffering from β – thalassemia major coming to the Paediatrics department of S.S.G. Hospital, Vadodara. Study tools used were Zarit Burden Interview, General Health Questionnaire-28, Diagnostic and Statistical Manual of mental disorders (fifth edition) diagnostic criteria for depressive disorders and generalised anxiety disorder, Hamilton Depression and Anxiety Rating Scales. Forty seven (47%) caregivers had moderate to severe burden of care. Fifty four (54%) caregivers screened positive for having psychiatric morbidity out of which thirty five (35%) had depressive disorders and fourteen (14%) had generalised anxiety disorder. 24 (68.6%) and 9 (64.3%) had moderate to severe depression and anxiety respectively. Burden of care and depression were significantly associated with lower income and those requiring blood transfusions every 2 weeks or less. Thalassemia has its impact not only on the patients but also on the mental health of their caregivers leading to high levels of depression, anxiety and burden of care in them. They should be routinely screened for depression and anxiety to provide adequate mental health care to these individuals.