Screening methods for thalassemia carriers which have been widely used in Thailand include the Osmotic Fragility Test (OFT) and Dichlorophenol-indophenol precipitation test (DCIP). Both methods have been shown to be effective for screening of severe thalassemia carriers including α thalassemia 1, β- thalassemia and hemoglobin E (HbE). There has been some concern about the efficacy of thalassemia testing in smaller hospitals in Thailand. Effective screening of potential thalassemia carriers in community hospitals can lead to improved prevention and control of this serious disease. The objective of this study was to determine the efficiency of thalassemia screening at three community hospitals in Nakhon Si Thammarat province. Three hundred and fifty nine pregnant women who attended an anti-natal care clinic were studied. All subjects were screened at these three community hospitals using the OFT and DCIP tests. Hb types and quantifications were performed using cellulose acetate electrophoresis and microcolumn chromatography to identify β-thalassemia carriers. α-thalassemia 1 carriers (SEA and THAI deletions) were identified by PCR. It was found that the overall efficiency of thalassemia screening at these three community hospitals was 58.8%. Fifty-one severe thalassemia carriers were identified. Thirty cases screened positive and 21 cases screened negative. Among the 21 screening negative cases, 2 α-thalassemia 1 carriers (SEA deletion), 2 β-thalassemia carriers and 17 subjects with Hb E were identified. The findings indicate that screening for severe thalassemia carriers at these three community hospitals in Nakhon Si Thammarat province are not effective and need further improvement.