Background: Erythrocyte sedimentation rate (ESR) is a simple and inexpensive blood test with low sensitivity and specificity.However, it can be affected by many factors and there is no limit value valid for all patients.Anemia is also a phonemenon that should be investigated for many diseases.Sedimentation is a criterion in the diagnosis and follow-up of diseases in which both inflammation and autoimmunity are considered to be involved in the etiology, such as temporal arteritis and inflammatory bowel disease.A sedimentation rate of 50 mm/h or less is an exclusion criterion in vasculitis.In this study, we aimed to determine the distribution of disease diagnosis in patients with elevated sedimentation above 50 mm/h and anemia. Materials and Methods:Ethics committee approval numbered B.30.2.PAÜ.0.20.05.09/187 was obtained for the study.The data of 300 patients with anemia and elevated sedimentation who were admitted to the Outpatient Clinic of Pamukkale University Hospital Internal Medicine and related subspecialties and who were hospitalized in the wards of Pamukkale University Hospital Internal Medicine and related subspecialties between November 2011 and November 2012 were retrospectively analyzed.Results: A total of 300 patients with ESR exceeding 50 mm/h and anemia were identified.Of the patients, 154 were female (51.3%) and 146 were male (48.7%).The mean age of the women was 59.08±19.0years and the mean age of the men was 62.4±14.1 years.The mean ESR was 77.55±21.21mm/h in women and 82.89±19.24mm/h in men.The mean hemoglobin was 10.31±1.60 g/dL in women and 10.69±1.52 g/dL in men.In the distribution according to disease groups, oncologic diseases had the highest rate (27.9%) and pulmonary diseases had the lowest rate (1%). Conclusion:No difference was detected in the diagnostic distribution of the patients after lowering the lower limit of ESR to 50 mm/h compared to the literature.When the correlation between hemoglobin and ESR was examined, it was determined that ESR increased as hemoglobin decreased.We recommend differential diagnosis with further investigation especially in patients with high ESR accompanied by anemia.