Purpose: Thalassemia poses clear systemic and oral health problems. Clinicians must be aware of various dental treatment needs in these patients. This study was undertaken to assess body mass index (BMI), dental age, salivary alkaline phosphatase levels, malocclusion, and treatment needs in children with β thalassemia major. Materials and methods: A total of 100 children within the age group of 2–15 years (50 thalassemic and 50 healthy controls) were included. Dental age, oral health status, malocclusion, and intervention urgency index was recorded. Unstimulated whole saliva samples were collected to assess the salivary alkaline phosphatase levels. The recorded data were statistically analyzed. Results: A significantly greater number of thalassemia children were found to be in the underweight category. A significantly high OHI-S scores and low gingival index scores were observed in thalassemia children. Salivary alkaline phosphatase levels were significantly low in thalassemia children compared to the control group. Intervention urgency index scores were significantly high in thalassemia group of children. Conclusion: Thalassemia children had low BMI, gingival index scores, salivary alkaline phosphatase levels and higher prevalence of malocclusion, and high OHI-S index scores compared to the healthy control group. Intervention urgency index scores revealed greater dental treatment needs in children with thalassemia.