Introduction: Anemia is a  major  global  health  problem,  especially  in developing countries like India, despite the fact that this problem is largely preventable & easily treatable. It is responsible for  morbidity  and  mortality  among  general population. The present study analysed the  type  of  anemia,  various  causative  risk  factors associated   with   anemia   and clinico-pathological manifestations  of  anemia  among  patients under department of general medicine, Hassan institute of medical sciences and srichamaranjendra teaching hospital, hassan, karnataka. Methods: A total of78 cases aging 18 to 80 years diagnosed as severe anemia based on WHO criteria of hemoglobin concentration were analysed for epidemiological, clinical and hematological parameters. A prospective observational study was conducted at HIMS, Hassan. Result: During the study period, a total of 78 severe anemia cases were included in the study. Of these 37.17%males, 62.8%females. Most prevalent in the age group of 41-50 years. Rural population 50%, urban 50%. Occupation more common in farmers 44.8%.The most common presentation was fatigue (73.08%). The common hematological finding was microcytic hypochromic blood picture (61.5%) with Iron deficiency anemia in 80.7% and nutritional cause being the most common etiology (47.43%). Conclusion: Severe anemia is more prevalent in rural areas and middle age groups with nutritional cause being most common etiology, measures to be taken by the government to ensure proper nutritional achievments and to prevent mild anemia progressing to severe anemia.