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Background: The oxidant/antioxidant balance is disrupted in anemia. Antioxidant capacity depends on antioxidant enzyme activity and some trace elements. This study aimed to evaluate oxidant/antioxidant status and its correlation with red blood cell indices and anemia severity in anemic patients. Methods: Blood samples were taken from 90 anemic patients and 95 healthy people. Circulatory miR-122 was assayed by real-time PCR. Malondialdehyde (MDA), pro-oxidant/antioxidant balance (PAB), supper oxide demitasse (SOD), glutathione peroxidase (GPxs) activity, total antioxidant capacity (TAC), and zinc were measured by colorimetric method. Selenium was also determined using atomic absorption. Results: Selenium and zinc decreased significantly in the case group (**P=0.004 and ***P=0.000). The amount of miR-122 up-regulated in the anemia (**P=0.003). MDA was significantly raised in the case vs control (***P=0.0002). PAB was higher in the case group (**P=0.005). SOD and GPxs activity was decreased along with TAC in anemic patients (*P=0.02, **P=0.008, *P=0.038). Zinc and PAB levels correlated with some red blood cell indices. PAB was associated with anemia severity. Conclusion: Increased PAB and decreased zinc/selenium increased oxidant levels in anemic patients. RBC indices and anemia severity were correlated with oxidant/antioxidant somewhere. [ABSTRACT FROM AUTHOR]