Cancer associated anemia (CAA) is a common yet frequently under recognized complication of malignancy, affecting nearly 75% of patients during the course of illness, with higher prevalence in hematological cancers.1 Chemotherapy induced anemia (CIA) is considered a diagnosis of exclusion and requires systematic evaluation in patients with hemoglobin levels below 11 g per dL or below the lower limit of normal, as recommended by NCCN guidelines. CAA may result from impaired red cell production, increased destruction, blood loss, or chronic kidney disease with reduced erythropoietin production. Severity is graded using CTCAE and WHO criteria based on hemoglobin levels and clinical consequences. The ESMO has published clinical practice guidelines highlighting that iron deficiency, both absolute and functional, is common in cancer due to inflammation driven hepcidin elevation. Functional iron deficiency is defined as serum ferritin ?100 µg per L with transferrin saturation <20 percent, while absolute iron deficiency is defined as ferritin <100 µg per L.2 Current guidelines recommend IV Iron, which bypasses impaired gastrointestinal absorption and provides faster and more reliable iron repletion than oral formulations in oncology settings.