Four patients with thalassemia major and well documented transfusional anamnesis were investigated sonographically. Beside the fibrous reaction of iron overload in the liver the outstanding finding was the grossly increased echogenicity of the normal sized fibrotic pancreas in transfusional hemosiderosis. Upper abdominal sonography may be an useful - noninvasive - method for the assessment of iron load in regularly transfused patients. Moreover, pancreatic sonography may be helpful as follow-up method of chelation therapy.
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