This study highlights the iron profile of myelodysplastic patients in the new era of hepcidin and its pro-hormone, pro-hepcidin. Previous studies have focused on the anemia of chronic renal failure, thalassemia, and hemochromatosis. No previous study has been specifically concerned with myelodysplasia (MDS). We determined if pro-hepcidin plays a role in iron overload in patients with MDS. Thirty adult patients with MDS and 20 healthy adults (controls) were selected. The results revealed a statistically significant difference in the mean of pro-hepcidin levels between the two groups (t: -3.28, P: 0.004). There was a weak positive correlation between pro-hepcidin and hematocrit (HCT; r=0.36, p=0.048). Neither age , subtype of MDS, female gender, soluble transferring receptor (sTFR), or ferritin affected the pro-hepcidin level in patients with MDS. In conclusion, patients with pro-hepcidin had a positive correlation with HCT. The role of ineffective erythropoiesis in regulation of pro-hepcidin is superior to role of chronic blood transfusion therapy.