Objective: To compare the effect of small doses of recombinant erythropoietin on anemia of patients with chronic kidney disease who need dialysis and those are not on dialysis. Design: Case-comparative study. Setting: Nephrology Department in Al-Salaam Teaching Hospital, Mosul. Methods: Eighty patients having chronic kidney disease (40 patients needed dialysis and 40 patients needed no dialysis) participated in the study. Epoetin alfa given s.c. in a dose of 4000 IU, 2 times weekly. Hemoglobin was measured before drug administration and every 2 weeks and at the end of the trial period (3 months). Result: A significant increase of hemoglobin level had been obtained after treatment with erythropoietin in both groups. Comparison between hemoglobin elevation of both groups ( 3.0 g/l for patients without dialysis and 2.9 g/l for patients with dialysis) revealed a non significant difference (P>0.5). Conclusion: the present study demonstrated that the administration of epoetin alfa, s.c. in a