Introduction: The purpose of the present study is to make aware of serious disease, its radiographic features and its implications on dental care, especially for general dental practioners working in different communities. Material and Methods: For the present study, 50 Thalassemia major patients of the age of 6 years and above as group I and 50 Age and Sex matched control subjects were selected as Group II. Panoramic radiographs were taken using standard radiographic procedure on Orthopantomograph __ampersandsignldquo;PLANMECA PM 2002 EC Proline__ampersandsignrdquo; Panoramic X-ray unit. Exposed Panoramic radiographs were processed manually. The processed radiographs were examined in subdued ambient light using transmitted light from a standard X-ray viewing box for radiographic features: spiky and short roots, enlargement of bone marrow spaces, thin lamina dura, identification of inferior alveolar canal, size of maxillary sinuses, taurodontism, and thickness of inferior mandibular cortex. Crown and root lengths were determined on panoramic radiographs by using Seow and Lai method. Results and Conclusions: Thus, it can be concluded from the present study that the results of this study suggest that following radiographic signs are evidence of thalassemia major: small / absent maxillary sinuses, spiky and short roots, taurodontism, enlargement of bone marrow spaces, identification of inferior alveolar canal, thin lamina dura, inferior mandibular cortex. Radiographic findings described above on orthopantamogram are not pathognomonic in itself but may be used in the field of dentistry as a diagnostic aid for thalassemia major.