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Primary myelofibrosis (PMF) is Philadelphia-chromosome-negative myeloproliferative neoplasm (MPN) characterized by bone marrow fibrosis, cytopenias, constitutional symptoms, hepatosplenomegaly, and extramedullary hematopoiesis. PMF-associated anemia is usually treated with androgens, danazol, erythropoiesis-stimulating agents (ESAs), immunomodulatory drugs (such as thalidomide, lenalidomide, pomalidomide), corticosteroids, and red blood cell (RBC) transfusions.The aim of our retrospective study was to evaluate the management of PMF-associated anemia in Armenia.The medical records of all patients diagnosed with PMF in Hematology Center in Armenia were analyzed retrospectively from 01/01/2010 to 12/31/2020.Between 2010-2020 the total number of patients was 238, 112 (47.1%) of which were alive by the time of data collection. Median age was 60 (28-88). Female patients were 102 (42.86%). At the time of diagnosis, 48 (42.86%) patients had anemia (Hb12g/dL) of which 12 (10.71%) mild anemia (Hb 11-11.9g/dL); 20 (17.86%) moderate anemia (Hb 8-10.9g/dL); 16 (14.28%) severe anemia (Hb8g/dL). Erythropoietin level was estimated only in one patient. In the majority of patients, anemia has correlated with chronic transfusions. At different stages of treatment, 23 (20.53%) patients were transfusion-dependent, 4 (3.57%) received androgens, 14 (12.5%) prednisone and 1 patient lenalidomide. Among all transfusion-dependent patients, no one has received iron chelation therapy. None of the patients underwent an allogeneic hematopoietic stem cell transplantation (HSCT) because it is not available in the Republic of Armenia. Treatment restrictions are due to financial reasons.Our work showed that due the significant diagnostic and therapeutic limitations in our country led to Inferior outcomes. The method of correlation of anemia in PMF patients is chronic transfusions, which also impairs the quality of life of patients.