Abstract: 　Objective　To explore the changes of iron overload in children with severe β-thalassemia pre- and post-splenectomy. Method The annual amount of blood transfused and serum ferritin (SF) levels of 18 children with severe β-thalassemia before and after splenectomy from January 2003 to December 2012 were retrospectively analyzed. Result The annual amount of blood transfused in children with severe β-thalassemia at one year and two years after splenectomy were (101.94±30.73) ml/kg and (96.50±34.00) ml/kg respectively, significantly lower than the amount of two years before splenectomy (241.89±73.66) ml/kg and one year before splenectomy (289.22±102.30) ml/kg (P<0.05). The SF levels at 6, 12, 18 and 24 months after splenectomy were (2 410.00±731.77) μg/L, (2 742.78±813.74) μg/L, (2 870.56±740.94) μg/L and (2 886.67±795.34) μg/L, significantly lower than that (4 975.00±1 245.85) μg/L of before splenectomy (P<0.05). Conclusions The serum ferritin level after splenectomy significantly decreases compared with that of before splenectomy, but still remarkably higher than that of normal controls. Monitoring of serum ferritin level and iron-chelating therapy are needed.