Iron deficiency anemia is a danger for children receiving home parenteral nutrition (HPN). For a study, researchers sought to find out how common iron deficiency anemia is in children with HPN and how effective each therapy method is. Over a 12-month period, data were collected retrospectively from children receiving HPN at a tertiary referral center (2015). Each patient had a complete blood count and ferritin and C-reactive protein levels were measured at least three times. At the start and conclusion of the trial, liver function tests were performed, and the number of blood transfusions/iron infusions was documented. There were 41 HPN patients identified (61% females, 51% motility problems, 29% enteropathy, and 20% short bowel syndrome). At the start of the trial, 83% of the youngsters were anemic, but by the conclusion, the figure had dropped to 73%. In 46% of patients, iron deficiency anemia was diagnosed and treated with blood transfusions, while iron infusions were used in 29%. There was no statistical difference in the degree of hemoglobin improvement between the two treatments (50% vs 33%, P=0.657), nor was there a significant difference in the level of hemoglobin (g/L) attained. However, the results for both were more favorable in the infusion group. Patients who received transfusions showed a considerably greater rate of impaired liver function than those who did not (93% vs 37%, P=0.009). Iron deficiency anemia is frequent in HPN patients’ children. Although blood transfusions are still used as first-line treatment for many patients, intravenous iron can be an effective option. Treatment plans are necessary.