OBJECTIVES: The epidemiological and economic burden associated with anaemia in patients with chronic kidney disease (CKD) in Europe has not been explored recently using systematic literature review (SLR) methods. Therefore, an SLR was conducted to assess these topics. METHODS:  A systematic search was conducted of MEDLINE- and EMBASE-indexed literature on anaemia in CKD from 2007 to 2012 for publications on epidemiology and economic burden. Data from included articles were abstracted into a pre-designed template and synthesised using qualitative methods. RESULTS: The review identified 19 studies reporting on epidemiology and nine on economic burden. The prevalence of anaemia among patients with CKD varied widely by setting, being generally lower in those from the general population and primary care (range: 1.0%–9.4%) than in general hospitals (range: 5.8%–43.3%), and highest in specialist nephrology settings (range: 16.0%–97.6%). Also, prevalence rates increased with the CKD stage (1–2: 14.1%–27.9%; 3: 25.5%–91.1%; 4: 36.0%–85.5%; 5: 97.6%). The cost of managing anaemia per patient per year varied across studies from £2,616 (2006–2007 Great British Pounds; GBP) to £3,740 (2006 GBP) in the UK, to €5,617 in France (cost year not reported). One study reported that the overall cost of managing anaemia was highest in patients with CKD Stage 3 compared with other stages (3: £4,162,056 vs. 4–5: £243,288; 2006–2007 GBP). Another study reported higher costs per patient per annum for individuals with lower haemoglobin (Hb) levels (Hb >12 g/dL: €2,418; Hb <10 g/dL: €13,005; cost year not reported). Among patients with CKD, those with anaemia were more likely to be hospitalised (61% vs. 50% of those without anaemia). CONCLUSIONS: Anaemia is a highly prevalent condition in CKD across treatment settings in Europe, and the limited evidence available suggests it is associated with a substantial economic burden.