Objective: To explore diagnosis value of the abnormal red blood cell morphology and red blood cell parameters test combined with bone marrow iron staining and serum ferritin in children with iron deficiency anemia (IDA). Methods: A total of 388 children with IDA were administrated by abnormal red blood cell morphology and ferritin(SF) content detection, and the bone marrow smear were detected by iron staining. We selected 388 patients with IDA and 255 patients with chronic diseases anemia(ACD) on detection of red blood cell parameters ［mean corpuscular volume(MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC) and red blood cell distribution width(RDW)］ and SF, and compared with 203 cases of healthy controls. Results: Abnormal morphology of red blood cells in 388 children accounted for about 56.25% to 92.34%. Iron staining of bone marrow cells increased with the increasing of serum ferritin detection index. Compared with the ACD group, MCV, MCH, SF in the IDA group were significantly decreased, RDW was increased, and the differences were statistically significant(all P<0.05). Compared with the control group, MCV and SF in the IDA group were significantly decreased; while in the ACD group, no obvious change of the MCV was found, SF was increased obviously, the difference was statistically significant(P<0.05). Combinding MCV, RDW and SF in diagnosis of IDA had the highest sensitivity, up to 99.9%. Combinding MCV, RDW and SF play a great role in diagnosis and differential diagnosis in IDA. Conclusion: Abnormal red blood cell morphology and red blood cell parameters test combined with bone marrow iron staining and serum ferritin in IDA in children has significant clinical value in the differential diagnosis.