Background: Heart failure due to iron overload is the most common cause of death in β thalassemia patients. Recent developments in the treatment of iron overload with improved chelation therapy have dramatically increased the expected lifespan of patients with β-thalassemia from less than twenty years in the 1960s to greater than forty years today. studies have shown that blood iron levels and liver iron measurements donot directly correlate with cardiac iron levels, as the hepatic and cardiactissues have different mechanisms and kinetics of iron uptake, storage and clearance. Therefore, assessing risk of heart failure from blood iron concentration or liver biopsy may not be accurate. MRI offers a noninvasive imaging study for assessment of tissue iron levels, and can be used to monitor iron burden in the heart and liver so that patients at risk for cardiac and liver failure can potentially be identified before lethal symptoms develop. MRI is increasingly being used worldwide to follow organ iron overload in β thalassemia patients, but can also be used to assess other types of patients with iron overload states including sickle cell disease and hemochromatosis.