Introduction: Extramedullary hematopoiesis in the adrenal gland is rare and is usually discovered incidentally. Thalassemia is one of the hematological disorders in which extramedullary hematopoiesis could be seen in many organs including adrenals Case report: Our patient was a nineteen years old Iraqi man. He is a known case of thalassemia major since the age of 5 months. He was discovered to has a right suprarenal mass by ultrasound examination as part of investigation for nocturia. The mass was surgically excised and the histopathological examination revealed extramedullary hematopoiesis. Conclusion: Awareness should be raised to consider the diagnosis of extramedullary hematopoiesis in any thalassemic patient with a tissue mass