To shed light over the natural history of aplastic anemia patients and to differentiate between the inherited form and the acquired forms, this retrospective study was conducted including 84 children with aplastic anemia. The medical records for patients were reviewed and data collected including: Age, gender, cause of aplastic anemia, first presenting features, symptoms and signs, history of the cause, family history, past history, frequency of blood and platelet transfusion, with special reference to different treatment received and response to treatment. Our patient were 40 females (47.6 %) and 44 males (52.4%), mean age of presentation was (5.4 ±4.5) years, 39 patients had acquired aplastic anemia, 20 patients were diagnosed as Fanconi anemia, 19 patients had PRCA, 3 patients had osteopetrosis, and 3 patients had dyserythropoietic anemia. In our patients most of aplastic anemia cases received cyclosporine alone, most of Fanconi patients (60%) received steroid alone, and (42.1%) patients with PRCA received steroid alone. In acquired aplastic anemia remission (complete or partial) was achieved in 10/29 (34.4%) of patients received cyclosporine alone, and the only patient received ATG with cyclosporine did not respond, and in patients received steroid with cyclosporine 2/4 (50%) achieved complete remission. In patients with Fanconi anemia remission was obtained in 3/12 (25%) of cases on steroid alone either complete or partial, and in patients received both steroid and androgen 1/4 (25%) achieved complete remission.