PURPOSE:  Macrocytic anemia is a state with mean corpuscular volume (MCV) more than 100fL. Various disease initially may present as macrocytosis. Thus, a detailed evaluation is required in every case of macrocytic anemia.

MATERIAL AND METHODS: This study was conducted on 500 patients of macrocytic anemia at Pt. B. D. Sharma PGIMS, Rohtak. Patients with any chronic medical illness were excluded.

RESULTS: Majority of cases belonged to age group of 15–29 years of age with male preponderance.  Pancytopenia was the most common hematological presentation. Megaloblastic anemia accounts for macrocytosis in 90% of the patients with MCV 110fL or more. Vitamin B12 was deficient in 84.5% cases with megaloblastic anemia. Non–megaloblastic causes include liver disease, aplastic anemia etc.

CONCLUSION: This study concluded that megaloblastic anemia is the most common cause of macrocytic anemia and likelihood of megaloblastic cause increases with MCV of >110fL.