In recent years, the incidence of diabetes has been on the rise worldwide, posing a serious threat to human health. Controlling blood glucose and reducing complications are the main goals of diabetes treatment nowadays. Oral anti-diabetic drugs (OHA) have become the main treatment means for diabetic patients and medical workers because of their advantages such as easy to take, non-invasive, easy to carry and keep, etc. According to statistics, more than 50% of type 2 diabetic patients in China are using oral anti-diabetic drugs. While paying attention to the hypoglycemic effect of the drugs, attention should be paid to the side effects caused by the drugs, such as anemia. Overall, the chances of anemia occurring in OHA are low, but in the face of such a large population of diabetics taking OHA, it should still be taken seriously enough. Drugs that may cause anemia include: 1. Sulfonylureas Sulfonylureas cause autoimmune hemolytic anemia through the mechanism of forming immune complexes or semi-antigens that cause the erythrocyte membrane to adsorb agglutinating antibodies or semi-antibodies, and the erythrocytes are easily destroyed in the monocyte-phagocyte system. 2.Biguanide drugs In some patients, long-term application of biguanide drugs can affect the absorption of vitamin B12 in the small intestine, causing VitB12 deficiency, leading to impaired DNA synthesis and the formation of megaloblastic anemia. 3.Thiazolidinediones Thiazolidinediones cause milder anemia, and the incidence is higher when combined with metformin than when used alone or with sulfonylureas. The anemia is now considered to be a dilutional anemia caused by drug-induced fluid retention. According to foreign studies, this trend of mild decrease in hematocrit stabilizes about 10-12 weeks after drug administration, and few patients develop anemia. In addition, some animal studies have shown that thiazolidinediones can contribute to the accumulation of bone marrow fat and cause anemia. 4, a glycosidase inhibitors Foreign literature reported that there were cases of weight loss and iron deficiency anemia after the use of a glycosidase inhibitors, which may be related to the reduction of iron absorption in the intestinal tract due to acarbose, as well as the patient’s overly restricted diet, insufficient iron intake and the possible association with ulcerative colitis, Crohn’s disease and other chronic enteritis. No similar findings have been found in other studies on acarbose in animals and humans. With the dramatic increase in the number of diabetics, the use of oral hypoglycemic drugs has become more widespread. Although there are fewer hypoglycemic agents that cause anemia, sufficient attention still needs to be paid when treating diabetes with oral hypoglycemic agents to avoid serious complications that could lead to a decline in the patient’s standard of living.