Anemia is the commonest medical disorder in pregnancy and contributes to 40–60% of all maternal deaths directly or indirectly. Prevalence of anemia in pregnancy ranges from 20% in developed countries to 50–90% in developing countries. Nutritional iron deficiency anemia is the commonest type of anemia in pregnancy. Anemia is associated with an increase in maternal and perinatal morbidity and mortality. The clinical presentation of anemia may vary from a completely asymptomatic woman with mild anemia to a severely decompensated woman with severe anemia. Overall improvement in diet is an important intervention to tackle nutritional anemia. WHO recommends universal oral iron supplementation of 60 mg of elemental iron and 400 ìg of folic acid once daily for 6 months during pregnancy and for additional 3 months postpartum in all developing countries with prevalence of anemia of > 40%. Routine iron and folic acid supplementation is recommended for all pregnant women in antenatal and postnatal period in countries with a high prevalence of anemia. The cause of anemia should be systematically identified and treated. Labor should be carefully supervised, observing strict asepsis and third stage is managed actively to minimize blood loss. Adequate blood, preferably packed cells are to be kept arranged. The second stage may be cut short by application of ventouse or outlet forceps to avoid cardiorespiratory embarrassment. Patient is counseled to continue hematinic therapy in the postpartum period and avoid next pregnancy for at least 2 years.