OBJECTIVE This study was to evaluate the differential diagnostic value of serum Hepcidin in elderly patients with iron deficiency anemia (IDA)and anemia of chronic disease (ACD). METHODS The group of IDA consisted of 28 elderly patients, and the group of ACD consisted of 21 elderly patients, the control group included 25 healthy elderly people. Hepcidin was measured by ELISA; WBC,RBC counts were assayed by haematology analyzer; the serum ferritin level was measured by using radioimmunoassay; C-reaction protein(CRP) and serum iron levels were assayed by a biochemical analyzer. RESULTS Hepcidin level between the three groups was significantly different (P < 0.01); serum ferritin,WBC and CRP levels in ACD patients were significantly higher than that in IDA patients (P < 0.01); according to the receivers operating characteristic (ROC) curve, the best threshold in diagnosis of IDA was 93.31 µg/L with the sensitivity of 88% and the specificity of 89%; the best threshold diagnosis of ACD was 130.05 µg/L with the sensitivity of 72% and the specificity of 96%. CONCLUSIONS serum Hepcidin has a certain value in the differential diagnosis of IDA and ACD in elderly patients.