Background: Anemia is a common and serious health problem, especially in premature infants. The objective of this study was to identify the determinants of anemia in premature infants and the factors influencing their hospital outcome. Methods: This was a retrospective study in the neonatal unit of the Mother Child Center of the Chantal Biya Foundation. Were included, all premature babies admitted between January 1, 2013 and December 31, 2017, who at least had a full blood count done. Data collected from medical records focused on maternal and neonatal characteristics, clinical and laboratory features, treatment received and hospital outcome. Results: Among the 425 premature babies included, 140 (32.9%) had anemia and 14 (10%) died. The risk factors for anemia in the premature infants were age at admission over 24 hours (p = 0.002) and gestational age less than 32 weeks (p <0.001). The factors associated with mortality were female sex (p = 0.030), birth weight <1500g (p = 0.029), gestational age <32 weeks (p = 0.024). The presence of respiratory distress (p = 0.009), thrombocytopenia (p = 0.011), the need for oxygen (p <0.001) and the need for blood transfusion (p = 0.004) were risk factors for death. However only bradycardia was an independent clinical feature associated with death (p = 0.037). Conclusion: Anemia is very common in premature babies, and remains a high risk factor for death. The clinical and laboratory monitoring of anemic premature babies must be rigorous especially in babies born very preterm and with very low birth weight.