Introduction: Transfusion-dependent thalassemia (TDT) is most commonly caused by defects in beta globin chain production. Iron overload, hypogonadism, vitamin D deficiency, adverse effects of desferrioxamine treatment, and delayed puberty due to loss of bone mass are the main complications of TDT. In the present study, we aimed to investigate bone complications and precursor markers in TDT patients. Materials and Methods: Our retrospective study included 93 patients, aged between 18 and 45, who were followed up in a tertiary care institution and did not have any disease other than TDT. The patients’ BMD values and biochemical parameters were compared. Results: Osteoporosis was observed in 33 of 93 patients, and the mean transferrin saturation of patients with osteoporosis was 60%, and the mean transferrin saturation of patients without osteoporosis was 42%. Patients with osteoporosis had transferrin saturation that was observed to be considerably higher than that of the group without osteoporosis (p = 0.006), with an average of 60%. Conclusion: Our investigation has demonstrated that in patients with TDT, elevated transferrin saturation may be a sign of osteoporosis.