Background: Anaemia, one of the most common manifestations seen in elderly patients is still a concern in the modern world as its prevalence increases with age. Higher mortality rates have been found in elderly who had anaemia in comparison to those who didn__ampersandsignrsquo;t. Anaemia greatly influences the quality of life, ability to recover from illness and functional capability. Objective: To study the patterns of anaemia in elderly patients in relation with RBC indices. Methods: An observational study of 100 elderly patients (visiting hospital including both OPD and IPD) with anaemia was done for four months in a tertiary care hospital to determine the aetiology behind the anaemia with the help of RBC indices. Results: Anaemia was categorized based on haemoglobin levels and patterns on the peripheral blood smear. It was found that in the elderly population most common pattern of anaemia was microcytic hypochromic due to deficiency of iron and high prevalence of chronic diseases. More than 50% of the patients in the study had moderate anaemia with RBC indices showing a wide range of values due to different etiological factors leading to anaemia. Conclusion: Anaemia is one of the major concerns in elderly as it accentuates morbidity and mortality and needs to be investigated thoroughly as most of the cases are treatable and only a few have unexplained anaemia. This being a hospital-based study only a few people could be evaluated, and so screening programs should be encouraged on a community level for older persons.