Background: Anemia is an important comorbidity in under-five children with severe acute malnutrition (SAM). The data on evaluation of SAM are limited. Aim: This study was done for analysis of incidence and types of anemia prevalent in SAM children. Materials and Methods: It was a hospital-based prospective observational study conducted from July 2017 to December 2018. A total of 260 children of age <5 years and who were confirmed cases of SAM were included in the study. A detailed demography and data regarding anemia and related variables hemoglobin, mean corpuscular volume, peripheral smear, serum ferritin, Vitamin B 12 , and folic acid levels, were recorded and analyzed. The data were entered into MS-Excel sheet and analysis was performed using SPSS version 21.0. Results: About 95% of anemia prevalence was found among children with SAM and most cases were of nutritional anemia (81.79%). About 54.33% of the children had mild anemia, with 79.75% had iron deficiency as the most common cause, followed by Vitamin B 12 and folic acid deficiency. Conclusion: The high prevalence of anemia suggests that it may contribute as a causal factor for hospitalization in severely malnourished children. We recommend future measures for prevention and control of anemia, including increased coverage of nutritional supplementation and fortification programs.

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