Nowadays the role of sonography (US) as a method of first choice in female pelvic pathology, is well determined. The authors used sonography in 23 patients aged between 13 and 36 years, affected by thalassemia major, in order to determine biometric and structural data of both uterus and ovaries. Morphological and clinical-laboratory studies have been performed in order to have a complete vision about the delay in ovarian maturation, commonly seen in these patients. Many cases of hypoplastic uterus and micropolycystic ovaries have been found. US, simple and widely diffused method, allow the evaluation of uterine and ovarian pathologic conditions and the relationship with ovarian maturation delay, and their follow-up. In some cases US may have a value in previewing menarche, in association with clinical-laboratory data.