This prospective, single institute, 6-month observational survey aimed to evaluate the prevalence, incidence,frequency, treatment of anemia, and trigger hemoglobin (Hb) level for initiating transfusion in patients withgynecologic malignancy. One hundred and eighty-six consecutive patients with gynecologic malignancy wereanalyzed between June and December 2009. Hb level data were collected for up to six data points or 6 months ofscheduled visits. Tumor type, disease status, cancer treatment and anemia treatment as well as trigger Hb levelfor starting treatment were evaluated. The mean age of patients was 51 years. Prevalence of anemia at enrollmentwas 66.1% (123/186), with 36 of 186 patients (19.4%) having moderate to severe anemia (Hb < 10.0 g/dl). Thehighest prevalence was found among patients with endometrial cancer (72.2%) and ovarian cancer (72%), newlydiagnosed/receiving treatment (70.9%) and those receiving radiotherapy (75%). The incidence of anemia was85.7% (54/63). Ovarian cancer had the highest association (87%). For disease status and cancer treatment, theincidence was highest in patients with persistent/recurrent disease (95.2%) and those who received radiotherapy(100%). One hundred and seventy-seven of 186 patients (95.2%) were ever anemic during the survey. Anemiawas frequently reported in patients with all tumor types (93-100%), persistent/recurrent disease (98.3%) andthose who received radiotherapy (100%) and 80.8% of patients who were ever anemic recieved treatment (oraliron, 42.9%; transfusion, 37.3%; and erythropoietic agent, 0.6%). In conclusion, the mean Hb trigger level forinitiating transfusion as treatment of anemia was 8.6g/dL. The prevalence, incidence, and frequency of anemiaare very high among patients with gynecologic malignancy; especially those with ovarian cancer, persistent/recurrent disease, and those receiving treatment.