OBJECTIVES: Recent recommendations (1) have underscored the need for anemia assessment and treatment, including iron, prior to scheduled orthopedic surgery. Administration of intravenous iron alone or combined to erythropoiesis stimulating agents (ESA) have also been shown to reduce transfusion requirements. However, the current practices are not well known. The aim of the present study was to assess the management of iron supplementation and anemia in patients with scheduled hip or knee surgery. METHODS: A total of 718 Anesthesiologists were selected from a professional file. Their daily practice on anemia management was evaluated through a questionnaire.   RESULTS: The survey analysis was performed on 117 questionnaires (return rate: 16%). The most frequent biological exams for anemia and iron deficiency prescribed by surgeons (45%), anesthesiologist (48%) or both (7%) before surgery were hemoglobin (100% of questionnaires), ferritin (35%), serum iron (33%), transferrin and Transferrin saturation (24%). Among the 117 anesthesiologists, 94 (80.3%) declared to prescribe ESA and 104 (89%) iron (oral, 29%; intravenous, 17%; both, 50%) before surgery. The main reasons to choose intravenous iron were combination to ESA (54%), short delay before surgery (43%), poor tolerance of oral iron (37%) or poor intestinal absorption (27%); intravenous iron was also used in the absence of ESA for 37%. In case of anemia after surgery, intravenous iron given in the first 24 hours was prescribed by 80% of anesthesiologist. When patient returned home, 65% of survey responders prescribed oral iron.      CONCLUSIONS: This survey shows that optimization of Hemoglobin before surgery with the use of ESA and iron is wide, but the exploration of anemia is infrequent, despite recent recommendations. Prospective studies aimed to assess the impact of intravenous iron alone or combined to ESA before elective orthopedic surgery are necessary. Prospective studies aimed at better defining the place of iron are still needed.