Background: Severe acute malnutrition (SAM) is a major public health concern affecting millions of children worldwide, particularly in low- and middle-income countries.This study aimed to evaluate the haemogram and iron profile in children suffering from severe acute malnutrition at a tertiary care center. The objective was to assess hematological abnormalities, iron deficiency, and their correlation to anemia in this vulnerable population. Materials and Methods: A hospital-based observational study was conducted on 110 children aged 6 months to 5 years diagnosed with SAM. Blood samples were collected and analyzed for haemogram parameters, including hemoglobin (Hb), total leukocyte count (TLC), differential leukocyte count (DLC), platelet count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Iron profile markers, including serum iron, total iron-binding capacity (TIBC), serum ferritin, and transferrin saturation, were also assessed. Results: The majority of children belonged to the 1-2 years age group (25.45%), with a male predominance (56.36%). The mean hemoglobin level was 9.2 ± 1.4 g/dL, indicating a high prevalence of anemia (70.00%). The mean total leukocyte count was 11.5 ± 3.2 x10³/µL, and platelet count was 270 ± 65 x10³/µL. The red cell indices suggested microcytic hypochromic anemia with an elevated RDW (16.8 ± 2.1%). The mean serum iron level was 45.6 ± 12.3 µg/dL, while TIBC was 385 ± 54 µg/dL, indicating increased iron-binding capacity. Serum ferritin was found to be 22.4 ± 8.9 ng/mL, reflecting depleted iron stores, and transferrin saturation was 14.8 ± 3.5%, confirming iron deficiency. Correlation analysis showed significant associations between hemoglobin levels and serum iron (r = 0.42), serum ferritin (r = 0.48), and transferrin saturation (r = 0.50), while TIBC exhibited a negative correlation (r = -0.35). Conclusion: This study highlights the high prevalence of anemia and iron deficiency among children with SAM. Hematological abnormalities, including low hemoglobin levels, microcytic hypochromic anemia, and increased TIBC, indicate widespread nutritional deficiencies. Routine screening of haemogram and iron profile parameters is essential for early diagnosis and targeted interventions. Nutritional rehabilitation, iron supplementation, and infection management are crucial in improving hematological outcomes and overall recovery.