Objectives: To study the effect of intravenous iron in the management of anemia in erythropoietin (EPO) treated hemodialysis patients with poor response to treatment with oral iron. Methods:Thirty-six patients (27 men and 9 women) with serum hemoglobin of less than 10 g/dl and a serum ferritin level of less than 500 mcg /l were included in the study. Each patient received 100 mg of intravenous iron at end of dialysis for 10 consecutive dialysis treatments, and once weekly of regular intravenous iron supplementation for another 13 weeks included in the study. All patients were receiving oral iron supplements (ferrous sulphate 325 mg twice daily), and were all also receiving EPO, a total dose of 8000 units per week, given subcutaneous as 4000 unit twice weekly throughout the study. The primary end point of this study was hemoglobin level at 4 months of starting intravenous iron supplementation. Results:The mean hemoglobin increased from 8.88 g/dl to11.18 g/dl over the period of the study (4 months) (p<0.0001). The mean serum ferritin increased from 179 mcg/l to 444 mcg/l over the same period (P<0.0001). Conclusion:Intravenous iron supplementation is very effective in correcting a poor response to EPO in hemodialysis patients on oral iron supplements.