Renal abnormalities are increasingly recognized in transfusion-dependent β-thalassemia, but evidence on intrarenal Doppler indices remains limited. This single-center case–control study compared the resistive index (RI) and pulsatility index (PI) in 44 patients aged 7–57 years and 30 apparently healthy controls aged 7–45 years. Three interlobar arterial measurements from each kidney were averaged for each participant. Group differences were evaluated using Welch’s t-test, and receiver operating characteristic analysis assessed discrimination between thalassemia and control status. Mean RI was higher in patients than controls (0.6789 ± 0.0500 versus 0.5943 ± 0.0440; mean difference, 0.0846; 95% confidence interval, 0.0626–0.1066). Mean PI was also higher (1.1655 ± 0.1824 versus 0.9197 ± 0.1290; mean difference, 0.2458; 95% confidence interval, 0.1736–0.3180). Both differences were significant (p < 0.001), with Hedges’ g values of 1.76 and 1.49, respectively. Areas under the curve were 0.895 for RI and 0.865 for PI. These findings indicate altered intrarenal hemodynamics in transfusion-dependent β-thalassemia. Without an independent kidney-injury reference standard or adjustment for potential confounders, they do not establish either index as a diagnostic marker of kidney injury.