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Oxidative stress is defined as a disturbance in the balance between oxidants and antioxidants in favor of the former, which leads to molecular and cellular damage. Free radicals play an important role in the pathogenesis of a large number of diseases. Thalassemic syndromes are increasingly perceived as diseases associated with oxidative damage. The premature hemolysis of erythroid cells and the oxidative effect of the free iron accumulated in the body due to the regular hemotransfusions are important for the reduced survival of the patients with beta-thalassemia Lipids are the most favored target for free-radical damage because they are easily oxidized. Lipid peroxidation is the main molecular mechnism of free radical toxicity. Malondialdehyde, in its role as an end compound of lipid peroxidation, is widely used as an index of oxidative status, respectively a measure of oxidative damage. It has been proven that the processes for its formation play a major role in the pathogenesis of premature atherosclerosis. In recent years, numerous studies have demonstrated elevated levels of malondialdehyde in transfusion-dependent patients with beta-thalassemia major. In this group of patients, altered vascular elasticity with thickening of the intima of the vascular wall and arterial stiffness are additionally demonstrated. A higher incidence of vascular complications, premature arterial aging and early atherosclerosis was also observed. Therefore, it is necessary to start the follow up and the evaluation of the carotid walls of the patients at an earlier age. [ABSTRACT FROM AUTHOR]