Macrocytosis in adults is defined as a red blood cell (RBC) mean corpuscular volume (MCV) >100 FL. Macrocytic anemia is generally classified into megaloblastic and non-megaloblastic anemia. The objective of this study was to assess haematological findings in patients of macrocytic anemia based on complete blood count and peripheral blood smear and to classify them based on clinical, serum vitamin B 12 and folic acid levels .The study was carried out over a period of one year at a tertiary care teaching hospital. 100 patients were selected on simple random sampling with MCV>99 FL and peripheral blood smear showing features of macrocytosis. Out of the 100 patients studied of macrocytic anemia, 55 percent had megaloblastic anemia and remaining 45 percent had non-megaloblastic anemia due to various causes. In our study, megaloblastic anemia was the most common cause of macrocytic anemia and among non- megaloblastic causes liver disorders like hepatitis was the most important cause.