Introduction: Anemia remains a major public health challenge worldwide, particularly affecting children under five years of age in developing countries. It contributes significantly to morbidity, impairs growth and cognitive development, and increases susceptibility to infections. Identifying clinical patterns and hematological profiles is vital to guide effective prevention and management strategies.

Methods:A retrospective descriptive study was conducted at a tertiary care center in Central India, including children aged 1 month to 14 years admitted between August and December 2019 with anemia at admission. Demographic data, clinical presentation, nutritional status, and laboratory parameters were collected from hospital records. Hematological indices and additional investigations were analyzed to determine anemia types and etiologies. Statistical analysis was performed using SPSS software, and associations were assessed with chi-square tests.

Results: Out of 610 admitted children, 182 (46.2%) were anemic. Male children (53.8%) slightly outnumbered females (46.2%), but the difference was not statistically significant. The highest prevalence was observed in children under five years (76.9%), with most cases showing moderate anemia (48.3%), followed by mild (28.5%) and severe (23.1%). Microcytic anemia was the most common morphological type (61.5%). Nutritional anemia predominated, with 43 cases of iron deficiency and 14 cases of vitamin B12 deficiency. Severe acute malnutrition (SAM) was present in 38 children and significantly associated with anemia severity (p = 0.028). Hemolytic anemias, infections, and pancytopenia also contributed to severe presentations.

Conclusion: Nutritional anemia remains the most prevalent and preventable cause of anemia in hospitalized children, strongly linked to poor dietary practices and malnutrition. Enhancing nutrition education, early screening for hemoglobinopathies, and strengthening public health interventions are essential to reduce childhood anemia burden.