【Objective】 To explore the clinical characteristics and the main points of treatment for the hiatal hernias patients with the first symptom of anemia. 【Methods】 Analysis of the clinical data of 9 cases of hiatal hernias patients whose first symptom was anemia.All the patients had been given the tests of routine blood,serum iron,serum ferrtin,total iron binding capactiy.besides these,they also had done the X ray of chest and upper gastrointestinal radiography. 【Results】 All the 9 cases met the of criterion of iron deficiency anemia.The mean level of the hemoglobin,serum ferritin,serum iron,total iron binding capacity was (52 ± 12)g/L,(3.0±1.8)ng/mL,(2.7±1.8)μmol/L,(87.21±5.78)μmol/L individial.All of them did not have the gastrointestinal symptoms such as"abdominal pain,vomitingand melena".The X ray of the chest showed abnormal,the diagnosis of hiatal hernias was proved by upper gastrointestinal radiography.8 cases had been given surgery,1 case family refused operation and gave up threatment. 【Conclusion】 Iron-deficiency anaemia is common for infants,it can be diagnosed easily by the tests of iron metabolism.It is important to find out the cause of iron deficiency,especially congenital malformation gastrointestinal tract such as hiatal hernias.The X-ray of chest should routinely been done to the patient of anemian to avoid misdiagnosis.Surgery is the key factor for the successful treatment.