A 91-year-old man had been treated for iron-deficiency anemia for four years before admission to the Geriatric Unit of the Hasharon Hospital because of cardiac insufficiency and epigastric pain. In the Unit, laboratory studies revealed, in addition to hypochromic anemia, a high level of plasma iron and a reduced iron-binding capacity. The low reticulocyte count in the peripheral blood despite hyperplasia in the bone-marrow erythrocyte series, the rapid disappearance of radioactive iron from the plasma, and the impaired erythrocytic uptake of iron were all indicative of the ineffective erythropoiesis. The findings suggested the possibility of sideroblastic anemia, and examination of bone-marrow aspirates stained for iron confirmed this diagnosis.