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Background: Anemia is a medical condition in which the red blood cells (RBCs) count and hemoglobin (Hb) are less than the normal range. The main causes of anemia are a decrease in RBCs, their destruction and decrease of Hb synthesis. A useful method for diagnosis and classification of anemias is based on the morphological appearance of RBCs on an ideal stained blood smear. The main terms used in such classification are normocytic normochromic, microcytic hypochromic and macrocytic anemia. Aim: The aim of this study is to determine the most common morphological pattern of anemia in Saudi anemic patients who were admitted at King Abdul-aziz Medical City-Riyadh. Materials and Methods: Retrospectively we evaluated the results of complete blood count (CBC) and peripheral blood picture (PBP) of all anemic patients attending during the year 2013 (from 1st January to 31st December). Results: Participants in this study included 150 patients (13 infants, 27 children, 12 youths, 52 adults and 46 old). The gender distribution showed 70 males and 80 females. The results of CBC and PBP showed that 113 (75.3%), 36 (24%) and 1 (0.7%) of the patients had normocytic normochromic, microcytic hypochromic and macrocytic pattern of anemia respectively. Conclusion: The normocytic normochromic pattern of anemia is highly frequent among this sample of Saudi patients while the macrocytic pattern of anemia is the lowest. According to gender groups microcytic hypochromic pattern of anemia is more common among females; malnutrition, increase of blood loss due to pregnancy or menstruation, and lack of iron absorption are the main causes, while the normocytic normochromic is highly frequent among males, which are mainly due to blood loss or chronic diseases. [ABSTRACT FROM AUTHOR]