Objective: Despite public health campaigns based on Fe and folic acid supplements, Fe-deficiency anaemia remains highly prevalent among women in India. We investigated leaf concentrate as an alternative to Fe and folic acid supplements for treating anaemia in adolescent girls. Design: Randomised controlled two-arm trial over 3 months: one group received daily Fe and folic acid (IFA; 60 mg Fe, 500 mg folic acid); the other daily leaf concentrate (LC; 5 mg Fe, 13 mg folic acid). Hb concentration, mean cell volume, serum Fe, serum ferritin and total Fe-binding capacity were measured pre-and post-intervention. Setting: Jaipur, India. Subjects: One hundred and two adolescent girls aged 14-18 years. Results: Of the 102 girls randomized to the two arms of the trial, four (3?9 %) were severely anaemic (Hb , 7 g/dl), twenty-eight (27?5 %) were moderately anaemic (Hb $ 7 g/dl, ,10 g/dl) and seventy (68?6 %) were mildly anaemic (Hb $ 10 g/dl, ,12 g/dl). In the IFA group, eleven girls (20?4 %) withdrew due to side-effects, compared with one girl (2?1 %) in the LC group (P 5 0?005). Total losses to followup were 14/54 in the IFA group and 2/48 in the LC group. At the end of the trial, none of the eighty-six remaining girls were severely anaemic, nine (10?5 %) were moderately anaemic and twenty-six (30?2 %) were mildly anaemic; fifty-one (59?3 %) had normal Hb levels ($12 g/dl). After adjustment for baseline values, LC was as effective as IFA in improving serum Fe parameters and treating anaemia. Conclusions: Leaf concentrate is an effective, and more palatable, alternative to Fe and folic acid supplements for treating anaemia in adolescent girls.