This cross sectional study was conducted on the patients with thalassemia major who received regular blood transfusions and compared between the molecular and serological methods to do blood typing. In comparison between ABO and Rh(D) typing the studies demonstrated that the results were nearly concordant, 99 100%, while, in comparison between the first level and the extended antigen typing the records showed that there were some discrepancies especially in Duffy and MNS systems. Molecular typing yielded clinically relevant information in 15 % of cases; the majority of such patients were hemolysis who received multiple transfusions. It also turned out to be more sensitive and specific to the distinctions and identification of rare phenotypes and serological uncertainties. Despite being more time consuming and expensive, it is still possible to say t hat molecular typing, can be beneficial for improving transfusion safety and efficiency in chronic transfused thalassemia patients, therefore, has its place in the concept of personalized transfusion medicine. Therefore, more work on the clinical and economic outcomes in the long term is needed.