摘要Background Pediatric anemia is a pervasive public health issue in Asia,significantly impairing children's growth,cognitive development,and future potential.This study evaluates trends,prevalence,and socio-economic disparities of pediatric anemia across Asia from 1990 to 2021,leveraging data from the Global Burden of Disease Study(GBD)2021 study.Methods Using estimated annual percentage change(EAPC)and Pearson's correlation coefficient,geographic variations and temporal trends were analysed alongside associations between prevalence,years lived with disability(YLDs),and Socio-demographic index(SDI).Results The study reveals a modest overall decline in anemia prevalence by 11.9％,from 464.53 million cases in 1990 to 409.07 million in 2021.High-SDI regions such as East Asia achieved significant reductions(-71.36％),with countries like Singapore,the Republic of Korea,Seychelles,Qatar,and the United Arab Emirates(UAE)showing substantial progress.In stark contrast,low-SDI countries,including Yemen(108.34％)and Afghanistan(130.28％),along with Cambodia,India,and Pakistan,experienced alarming increases.Dietary iron deficiency was the dominant cause,followed by hemoglobinopathies and neglected tropical diseases.Females,particularly adolescents,and children under five faced disproportionate burdens,with prevalence rates in low-SDI regions exceeding 47,000 per 100,000 compared to＜10,000 per 100,000 in high-SDI areas.Conclusions These findings emphasize profound regional and socio-economic inequalities in anemia burden.Urgent,evi-dence-based interventions are imperative,focusing on enhancing nutrition,expanding healthcare access,and integrating sex-sensitive strategies to address this multifaceted issue.Strengthened policies and targeted actions are critical to mitigating the burden and fostering health equity,particularly in vulnerable low-SDI regions.