Background: Anemia is commonly observed in elderly population, and the prevalence of anemia increases with advanced age. Anemia is a sign of poor health state and increase adverse outcomes in the elderly. Therefore, assessment of anemia is important in elderly patients. Objectives: The aim of this study was to classify the type of anemia and to assess the current state of anemia evaluation in the elderly population. Methods: Medical records-based retrospective study was performed for patients who were more than 80 years (>80) old and visited Dongguk University Ilsan Hospital from April 2005 to February 2014. Results: Total 548 patients who had anemia according to WHO criteria were identifi ed. The median age was 85 years old (range, 82-99) and median hemoglobin level was 11g/dL (range, 2. 7-12. 9). Twenty eight, 468, and 52 patients were classifi ed as microcytic anemia, nomocytic anemia, and macrocytic anemia, respectively. Among them, 397 patients (72. 4%) did not underwent proper the evaluation for the cause anemia. In detail: 8 (28. 5%) of microcytic anemia, 361 (77. 1%) of normocytic anemia, and the 28 (53. 84%) of 52 macrocytic anemia patients. The remaining 151 patients (27. 6%) had completed the evaluation, and 24 patients (15. 9%) were diagnosed as solid or hematologic malignancies. Conclusions: This fi nding showed physicians often neglected anemia in elderly over age 80. Though the patients have limited life expectancy, physicians need to discriminate the sub-population who will be benefi t from adequate evaluation and treatment.