Background: Anemia is one of the most common hematological conditions of infancy and childhood. It has been recognized as a major health problem due to its negative impacts on mental and physical development during childhood. Anemia is the world's second leading cause of disability. Aim of the study: To assess the effect of chronic anemia on physical growth and development among children under five years. Research design: A cross sectional descriptive research design was used for this study. Setting: Pediatric Hematology Clinic at Minia University Hospital for Obstetric and Pediatric. Subjects: A purposeful sample of 100 children diagnosed with any type of chronic anemia aged from (6 - 59 months) with their caregiver. Tools of data collection: Tool I: A structured interview questionnaire, Tool II:  Denver Developmental Screening Test 2nd edition (DDST II). Results: Mean age was 29.71 ± 16.02 months. It was found that children with chronic anemia had delay in all growth parameters. It was found that three fourths of studied children had abnormal development. It was found a relation between some growth parameters, Denver Developmental Screening Test 2nd edition (DDST II) and severity of disease among those children. Conclusion: Children with chronic anemia showed delayed growth and development, and also showed malnutrition. Both moderate and severe anemia was the most common among those children and both close and remote consanguinity was the most common among their parents. Recommendations: Increase awareness among mothers through educational programs on importance of follow up and care of their children with chronic anemia, regular follow up of those children with regular assessment of growth and development, nutritional counseling to parents and more efforts are still needed to increase awareness among people about importance of premarital counseling and health hazards of consanguineous marriage through mass media.