Background: Anemia in chronic kidney disease (CKD) is typically normocytic normochromic but can become microcytic hypochromic due to iron deficiency or hypoproliferative from reduced erythropoietin (EPO) activity. The aim is to investigate the spectrum of red blood cell parameters and morphology in anemia associated with chronic kidney disease. Research questions 1. What are the types of anemia seen in patients with chronic kidney disease? 2. What is the severity of anemia in patients with chronic kidney disease? Objectives 1. To describe the changes in various RBC parameters in Chronic Kidney Disease 2. To identify the morphologic spectrum of anemia in Chronic Kidney disease. 3. To assess the severity of anemia. Methodology: 125 samples were chosen as per the KDIGO guidelines criteria regardless of its primary cause, during the study period. The selected patients were analysed for RBC Count, Hemoglobin, Hematocrit, Mean Corpuscular Volume, Mean Corpuscular Haemoglobin , Mean Corpuscular Hemoglobin Concentration and peripheral smear for type of anemia and features of hemolysis.All data were entered using Micosoft Excel and analysis was done using IBM SPSS software version 27.0. Results: In the study, predominant age group was 60-80 years range, comprising 46.4% with a male preponderance (57.6%). The majority of patients, 54.4%, were in Stage 5 CKD. 53.6% cases showed moderate anemia. The vast majority of cases (74.4%) had normocytic normochromic anemia, indicating that red blood cells have normal size and hemoglobin concentration. There were statistically significant association between sex and CKD stage and hemoglobin levels and CKD stage. Conclusion: The present study highlights the morphological spectrum and RBC parameters of anemia in chronic kidney disease (CKD) patients. These findings underscore the need for proactive management of anemia in CKD to improve patient outcomes and quality of life.