OBJECTIVES: To investigate the real-world diagnosis and treatment patterns of iron deficiency anemia (IDA) in China. METHODS: Literature review, Key Opinion Leaders survey, and patient case review were conducted. The review was based on China Academic Journals Full-text Database (2006-2010). A total of 163 publications were targeted by searching in terms of IDA diagnosis and treatment. A total of 44 senior physicians specialized in nephrology, hematology and obstetrics/gynecology were selected from tertiary hospitals in Beijing, Shanghai, Guangzhou, Shenyang and Chengdu, who were requested to complete a questionnaire in two weeks. The structured questionnaire included IDA awareness, diagnosis, treatment and related drivers and restrictions. Information on Lab tests and treatments were collected from 91 patient cases. Descriptive analysis was performed. The results of KOL survey and patient case review were consistent, indicating the validity of the results. RESULTS: IDA was most likely found in patients in nephrology and obstetrics/gynecology, and in patients with chronic kidney disease on hemodialysis. Seventy-five percent of nephrologists, 58% of hematologists, and 25% of obstetricians/gynecologists reported the existence of hospital-wide guidelines for IDA diagnosis and treatment, respectively. Lab tests and cut-off for IDA diagnosis varied across different specialties and different physicians in the same specialty. Intravenous (IV) iron was more effective and caused less side effects than oral iron. IV iron sucrose increased  hemoglobin level faster and greater than intramuscular iron dextran. Nephrologists usually prescribed IV iron as the first line, while hematologists and obstetricians/gynecologists preferred oral iron. Price was not the most influential driver for using IV iron. Fifty-seven percent of KOLs, however, reported the restrictions of IV iron use due to cost. CONCLUSIONS: Guideline-based diagnosis and treatment for IDA needs to be strengthened in China. Real-world prescription of IV iron for IDA varied across specialties and may be restricted due to cost despite its better effectiveness.