Background: Pancytopenia is an important clinicohaematological entity encountered in our day to day clinical practice. Pancytopenia refers to reduction in all the three major formed elements of blood, red blood cells, white blood cells and platelets. It’s not a disease entity but a triad of findings that may result from a number of disease processes primarily or secondarily involving the bone marrow. The severity of pancytopenia and the underlying pathology determines the management and prognosis of patient. Objective: To study the etiopathology of pancytopenia, spectrum of haematological changes in various causes of pancytopenia. Methods: Study carried out on the patients admitted in the Dept. of Medicine, VIMSAR, Burla who had HB<10mg/dl, TLC <4000/cmm and Platelets <1lac/cmm. Haematological and other investigations: CBC, Peripheral smear examination, Reticulocyte count, Urine routine & microscopy, Renal function test, Serological investigation, Blood culture, HIV, HBV, HCV, Abdominal USG, Serum electrophoresis was done. Bone marrow aspiration using standard method was done whenever indicated avoiding the cases where causes of pancytopenia was obvious. A written informed consent obtained from all the patients after fully explained the purpose and procedure. Results: The observations are based on 100 cases of pancytopenia reported on routine haematological investigation in the Department of Medicine of VIMSAR, Burla having male to female ratio 0.92:1. 62% of patients presented with fever, easy fatigue were the 2nd most common complain present in 57%. Primary or idiopathic aplastic anemia was the most common etiological factor followed by malaria and sepsis which was sharp contrast with most of other study conducted in our country. Conclusions: Pancytopenia is not an uncommon haemotoligical problem encountered in clinical practice and should be suspected on clinical ground when a patient presents with unexplained anemia, prolonged fever and tendency to bleed.