OBJECTIVE: To study the clinical utility of measuring reticulocyte hemoglobin content (CHr) in the diagnosis of iron deficiency anemia (IDA) in children. METHODS: One hundred children with IDA at ages of 1 to 6 years and 50 healthy children were enrolled. Red blood cell parameters, CHr, hemoglobin (Hb), red blood count (RBC) and mean corpusular volume (MCV), were determined using the Blood Cell Analyzer. Serum ferritin (SF) levels were determined using radioimmunoassay double antibody techique. Soluble serum transferrin (sTfR) levels were determined using ELISA. RESULTS: The values of Hb (100±6 g/L vs 126±8 g/L) and CHr (18±5 pg vs 31±3 pg) in the IDA group were significantly lower than normal controls (P<0.01). SF levels (11±4 μg/L) in the IDA group were also lower than normal controls (59±36 μg/L) (P<0.01). In contrast, the values of sTfR in the IDA group were significantly higher than normal controls (4.8±2.1 mg/L vs 1.4±0.6 mg/L; P<0.01). In both groups, there was a positive correlation between the values of CHr and Hb［r=0.540 (control group), r=0.734 (IDA group); P<0.01］. In the IDA group, CHr was positively correlated with SF(r=0.464; P<0.01) and negatively correlated with sTfR(r=-0.450; P<0.01). When the cut-off value of CHr was 27.8 pg, the sensitivity and specificity for the diagnosis of IDA were 88.0% and 90.0%, respectively and the area under the ROC curve was 0.948. CONCLUSIONS: CHr can be used as an index for the diagnosis of IDA in children.