Objective: Anemia is a prevalent condition in patients who are under treatment for cancer. Having an instrument that can assess the impact of this potentially debilitating condition is relevant to the patient and health care provider. Our objective was to evaluate the psychometric properties of the FACT-An for anemic cancer patients. Methods: A comprehensive literature review was performed to summarize the psychometric properties of the FACT-An and its subscales including the FACT-Fatigue and the FACT-General for anemic cancer patients. Published papers and abstracts were retrieved by searching Medline 1992–2007, the Cochrane Library and related websites. Relevant articles cited from these search findings were also reviewed. Key search terms included: anemia, neoplasm, quality of life and erythropoetin. Results: Of 272 citations, thirteen articles were included for critical review. Nine papers reported satisfactory internal consistency (Cronbach's alpha = 0.79-0.96) for all subscales except for non-fatigue subscale (0.59-0.79). However, only two studies reported adequate test-retest reliability (Intraclass correlation coefficient = 0.82-0.90). There was acceptable criterion validity with significant (p<0.05) correlations (r=0.18-0.40) between the instrument and hemoglobin (Hb) levels. Each domains of the FACT-An showed acceptable convergent validity with Piper Fatigue questionnaire (r=0.52-0.79) and Multidimensional Fatigue Symptom Inventory (r=0.49-0.89) and showed divergent validity with Marlow-Crowne instrument, which measured the social desirability (r=0.04-0.18). The significant (p<0.05) differences in the FACT-An scores between the patients who had high Hb levels and low Hb levels showed satisfactory discriminative validity. Minimally important differences ranged 4.24-7.0 were examined using anchor based method, distribution based method and regression analysis. The acceptable responsiveness to change (effect 0.32 for the FACT-An; standardized response mean = 0.39 and Guyatt's responsiveness = 0.55 for the Fatigue subscale) were investigated. Conclusion: The FACT-An demonstrated overall acceptable psychometric performances as a discriminative and evaluative instrument for anemic patients, although evidence could be strengthened with further research.