Anemia is the lower level of hemoglobin concentration in men and women due to various reasons. There are many types of anemia depending upon how they are developed. One type of anemia is macrocytic anemia. In macrocytic anemia the RBCs are larger than the normal (macrocytosis) with MCV about 110 fl. The normal value of MCV is 80-100 FL. Macrocytosis either associated with anemia or it is without anemia. Because sometimes RBCs are larger due to some other reasons i.e. in pregnancy, new borne babies and infants. There are two categories of macrocytic anemia. 1) Megaloblastic and 2). Non-megaloblastic. Megaloblastic anemia is associated with bone marrow in which DNA synthesis is impaired due to nutritional deficiencies such as folic acid and vitamin B12. While non-megaloblastic anemia is associated with general circulation. It is not related to nutritional deficiencies. Alcohol, liver disease and some other problems cause non-megaloblastic anemia. In megaloblastic anemia large oval shaped RBCs are present in bone marrow while in non-megaloblastic anemia large round shaped RBCs are present in general circulation. Their symptoms and treatment vary depending upon the type of anemia.