A hemoglobin level of over 10 gm per 100 ml has been maintained by transfusion in six children with thalassemia major. Chelating agents have been used to minimize the increase in iron loading. Striking clinical improvement with regression of abnormal cardiac symptoms and signs was seen in all these patients. It is concluded that, in thalassemia major, this therapy provides at least short-term clinical benefits to severely affected children. The rationale for long-term, intensive transfusion therapy is based on the assumption that it is the degree of anemia rather than the degree of iron loading which leads to the eventual cardiac failure and death in these patients. Proof of this hypothesis will depend to some extent on the subsequent clinical course of these children.