Thalassemia treatment still relies on supportive care, including mainly blood transfusion and iron chelation therapy. Iron chelation therapy is considered the main responsible factor for the marked improvement in survival of thalassemic patients. Hemosiderosis should be prevented with appropriate chelation therapy from early childhood, timely dose adjustment according to changing body weight, as well as close monitoring of organ iron overload. Three iron chelators are currently available and the choice of appropriate chelator or their combination in pediatric population is individualized, depending on iron overload in target organs, patient age, adverse events and compliance issues, due to the limitations in their administration.