Beta-thalassemia major (β-TM) is a prevalent hereditary condition. Because they are highly prone to infection, the patients will have higher rates of infection-related death and morbidity. Meteorin-like protein (METRNL) a minor secreted protein and weighs about 28 kDa, which comprise 311 amino acids. This study aimed to evaluation immune inflammatory markers METRNL in sera patients with β-TM groups. Thalassemia Unit" at the "Al Zahra Teaching Hospital" in Najaf, Iraq, registered 60 patients with β-TM, including children and adolescents. They were 28 females and 32 males, ages 7 to 20. during the January–March 2022 timeframe. In the current study, it is found a significant increase in serum levels of FSG, insulin, and HOMA-IR, as well showed significantly lowered in BMI, HOMA-β, and METRNL in patients with β-TM as compared with control group. The linear regression analysis showed that the levels of FSG, insulin and HOMA-IR were significantly negative correlation with METRNL. ROC curve form METRNL that might be diagnosis of patients with β-TM with an AUC (0.748), the cut-off value was 29.0025 (ng/mL) for serum METRNL (95% CI: 0.585-0.911; p=0.003), a sensitivity of 73.3% and a specificity of 78% were acquired for METRNL in β-TM patients. The lower serum METRNL levels in β-TM patients than the healthy group, may be used potential risk indicator of the patients' worse prognosis, for induces endothelial dysfunction and lead to inflammation in most organs tissues could be later outcome to heme induce damage.