Aim: To determine the frequency of cardiomyopathy in children having Thalassemia major diagnosed on the basis of Echocardiography. Study Design: A cross-sectional study. Place and Duration: Paediatric department at Peoples medical college hospital (PMCH), Nawabshah from September 2019 to March 2020. Methodology: A total of 236 Thalessemic children visiting as outpatients or inpatients meeting inclusion criteria were enrolled. Informed consent was taken from the patients or their attendants. All demographic variables that included age, gender, address, educational status, family history, age of diagnosis of the disease, start of treatment and number of transfusions graded as none, occasional, were included. Echocardiography findings were performed and then recorded. Results:  Mean age of the patients was 10.60±4.064 (5-18) years, 110(49.1%) study subjects were female and 126(50.8%) were male patients. While 75(31.78%) study subjects have family history of thalassemia. A total of 87(36.9%) study subjects have left ventricular dysfunction, 13(14.9%) have global dysfunction, 11(12.6%) have isolated systolic dysfunction and 63(72.4%) have isolated diastolic dysfunction. Conclusion: In -thalassemia, heart disease is the key determinant of prognosis and survival. In this study we found a significant number of thalassemia children having cardiac involvement and ventricular dysfunction.