This study aims to examine the relationship between ferritin status and the incidence of hypogonadism in children with transfusion dependent thalassemia. A cross-sectional study was conducted on thalassemia patients at Haji Adam Malik General Hospital Medan from March to May 2021. Each subject was interviewed and blood was drawn before transfusion for laboratory examination. The data was analyzed using the Mann-Whitney test and the Fisher Exact test. From 31 subjects who had met the inclusion and exclusion criteria, mean ferritin levels was 1684.39 ng/mL. The results of gonadal hormones examination, such as progesterone, estrogen and testosterone were low in 17 patients (p<0.001). There was a significant association between the ferritin status and hypogonadism in ? thalassemia major children at Haji Adam Malik General Hospital Medan.