The management of large mean red blood cell volume needs to be determined according to the patient’s other indicators, as well as the clinical manifestations. If only the mean red blood cell volume is large and other indicators are normal, regular observation is sufficient. If there are changes in other indicators, then targeted treatment is needed. 1. If the patient only has a large mean red blood cell volume without other abnormalities, anemia or hematopoiesis, regular follow-up is sufficient, and the mean red blood cell volume may return to normal during subsequent observation. 2. If the mean red blood cell volume is large and accompanied by anemia, then it may be necessary to consider macrocytic anemia, which requires causative treatment. 3. Common causes of macrocytic anemia include megaloblastic anemia and myelodysplastic syndrome. For megaloblastic anemia, vitamin B12 and folic acid can be supplemented; for myelodysplastic syndromes, symptomatic treatments are needed, such as blood transfusion, hemostasis and anti-infection, and sometimes combined with chemotherapy. The above drugs should be used under the guidance of professional doctors, and when patients have an increase in the average size of red blood cells, they should seek professional consultation and treatment to avoid delaying their condition.