Celiac disease is a syndrome characterized by damage of the small intestinal mucosa caused by the gliadin fraction of wheat gluten. Celiac disease is a life-long inflammatory condition of the gastrointestinal tract that affects the small intestine in genetically susceptible individuals. Serological tests developed in the last decade provide a non-invasive tool to screen both individuals at risk for the disease and the general population. Aim of the study: To study the clinical presentation and details of pathological changes of celiac patients, also to evaluate the risk factors of celiac disease and finally to evaluate the serological diagnostic measures and their correlation's with tissue diagnosis. Patients. Metdods & MateriaCs: A total of 93 consecutive cases with malabsorptive symptoms were included in this study. Their ages ranged from 1-18 years. Small bowel biopsies were done and blood samples were collected at Iraqi Center of Gastroenterology and Hepatology and The University Teaching Hospital of Iraqi College of Medicine from all subjects enrolled in this study, from beginning of September 2001 to the end of April 2002. The following serological tests were performed:- 1-Anti-tissue transglutaminase antibody (IgA) by enzyme linked immunosorbant assay (ELISA). 2- Anti-gliadin antibody (IgA) by ELISA. 3- Anti-gliadin antibody (IgG) by ELISA. 4- Total serum IgA level by single radial immunodiffusion test (SRIDT). "ResuCts: Based on histopathological assessment, the current study revealed out of 93 symptomatic cases, 58 (62.4%) were proved to have celiac disease. Fifty percent of them with Marsh III C stage followed by 22.4 % III B& 27.6% III A. Regarding the clinical presentation of celiac patients, 32.8% of them were aged between 10-14 years, followed in order of frequency by < 5 years of age (25.9%). Chronic abdominal pain and bloating were the most predominant clinical complaints (74.1%) among celiac patients, followed in order of frequency by chronic diarrhea (69%), steatorrhea (67.2%) and short stature (63.8%), also there was a statically significant differences in the prevalence of chronic abdominal pain, bloating, chronic diarrhea, steatorrhea and muscle wasting among celiac patients more than non-celiac patients. The growth assessment of celiac patients shows that (77.6 %) and (65.5 %) of them were below 3rd centile of height for age and weight for age respectively. Breast-feeding and late introduction of wheat were not shown to have a protective role against the development of celiac disease. Anti-tissue transglutaminase antibody was the most useful supportive diagnostic tool. The specificity and positive predictive value were 100 % for both. Although, anti-gliadin antibody (IgG) was show 77.6 % sensitivity, but both anti-gliadin antibody (IgG & IgA) tests were much less specific than tissue-transglutaminase. In addition, this study shows a statistically highly significant correlation between the severity of histopathological changes and the titers of all three serological tests which applied (tTG & AGA). The serum level of total IgA was deficient in 15.5 % of celiac patients (N =58) with one symptomatic (non-celiac) patient shows deficiency of total IgA level (N = 35). Cone Cus ion: 1. Small bowel biopsy was mandatory for the diagnosis of celiac disease. 2. Tissue-transglutaminase test was a good diagnostic tool but negative result did not exclude the disease. 3. There was a significant correlation between the positivity and titers of (tTG & AGA) tests and the severity of histopathological changes. 4. Celiac disease was more common in subjects with total IgA deficiency than in people with normal levels of immunoglobulins, so screening with anti tissue-transglutaminase (IgG) should be performed in such cases.