Background: Anemia is very common during critical illness and results from two main factors: inflammation and iron deficiency. Hepcidin, a peptide hormone made in the liver, is the principal regulator of systemic iron homeostasis.  Objective: We aimed in this study to improve the prognosis of anemia in critically ill patients through assessment of serum hepcidin and iron levels in critically ill anemic patients admitted to the medical ICU of Zagazig university hospital and to find out the relationship between levels of serum hepcidin and outcome of critically ill anemic patients. Patients and Methods: This study was a prospective study that was conducted on 80 patients who fulfilled the inclusion and exclusion criteria were diagnosed, assessed, received medical support, and followed during their stay in MICU. Results: The mean Hb and hematocrit levels were 9.7±1.3 g/dl and 28.9±4% respectively. Serum hepcidin and serum ferritin levels are markedly elevated among critically ill anemic patients in MICU compared to what is reported in the literature for the general population which reflects the relationship with inflammation. Serum Hepcidin was not correlated with any serum Hb, hematocrit, APACHE II score, or ICU length of stay. Serum hepcidin level had no impact on mortality of the study population in MICU. Conclusion: Serum hepcidin and ferritin levels are significantly elevated in critically ill anemic patients who are characterized by the inflammatory stress of their illnesses. Serum hepcidin level measured on admission to medical ICU has no impact on patients' short-term ICU outcome in terms of mortality or length of hospital stay.