Background: Pancytopenia refers to the concurrent presence of anemia, leukopenia, and thrombocytopenia. It may be classified as either primary or secondary. The examination of bone marrow is of significant importance in elucidating the etiology of pancytopenia. The objective of this study is to ascertain the etiology of pancytopenia, to determine the prevalence of various diseases contributing to pancytopenia, and to evaluate the significance of bone marrow examination in such cases. Materials and Methods: This research was undertaken in the vicinity of Kanpur, Uttar Pradesh, over a span of three years across various healthcare centers. Patients exhibited a range of symptoms. A bone marrow aspiration and biopsy were conducted on the patients, specifically from the posterior superior iliac crest. Aspiration smears were subjected to staining using the Leishman stain for microscopic examination. Prior to the placement of the tissue in 10% neutral buffered formalin fixative, touch imprints of the bone marrow biopsy were prepared and subsequently analyzed. Results: A total of 150 cases were studied during a period of three years. Age of patients range from 1 year to 60 years. 69 cases were female and 81 were male. The commonest cause of pancytopenia was megaloblastic anemia seen in 23 cases (46%) followed by nutritional anemia seen in 7 cases (14%), 5 cases (10%) were Aplastic anemia, 4 cases (8 %)were acute myeloid leukemia, 3 cases (6%) were acute lymphoblastic leukemia, 3 cases(6%) were lymphoma, 3 cases (6 %) were multiple myeloma, 1case (2%) was chediak higashi syndrome and 1 case (2%) was malaria. Conclusion: Bone marrow study helps in the diagnosis of cause of pancytopenia and also helps in planning for further investigations and management.