Abstract: Objective To investigate the incidence and etiology of anemia in hospitalized elder patients and their clinical significance. Methods The hospitalized elder patients admitted to Chinese PLA General Hospital in November 2013 were recruited to screen anemic patients using hemoglobulin levels of< 120 g/L in male and< 110 g/L in female. Thereafter, systematic review for the screened elderly anemic patients, including general clinical information, etiology of anemia, red blood cells related parameters in complete blood counts, iron metabolism related parameters, folic acid and vitamin B₁₂, was performed, and the clinical features of the parameters mentioned above were analyzed. Results Of the 406 old patients hospitalized in the same period, anemic patients accounted for 33.5% with mean age of 88.7 years old, in which patients aged over 80 years old accounted for 90.4%. Among the elderly anemic patients, mild to moderate anemia comprised 99.2% and most patients (70.6%) were normocytic normochromic anemia. The etiology for 136 elderly anemic patients included infection (52.9%), malignant solid tumors (14.7%), chronic kidney failure (13.2%), undetermined anemia (7.4%), malignant hematological diseases (5.9%) and hematopoietic materials deficiency and blood loss (5.9%). Further etiologic analysis showed that single etiology was seen in 77 cases (56.6%), multifactor in 49 cases (36.0%) and the remainders were undetermined anemia. Hemoglobulin mean of multi-etiologic anemic patients was (95.3±13.8) g/L, which was less than those of single-etiologic anemic patients (102.6±12.2) g/L (P< 0.05) and undetermined anemic patients (109.8±6.9) g/L (P< 0.05). Among the elderly anemic patients, only 8 cases were hospitalized in department of geriatric hematology, while the remainders were first hospitalized for non-hematological diseases in other departments and then anemia was diagnosed as comorbidity. Conclusion The hospitalized elderly patients are prone to anemia and etiology for anemia is complex. Among those elderly anemic patients, mild to moderated anemia is the most seen symptom with lack of specific clinical manifestations. And diagnosis of anemia is often made in the process of treating other non-hematological diseases.