[Abstract] Objective: To assess the significance of detecting the CD41 linked micromegakaryocyte staining in differential diagnosis of anemia in the elderly. Methods: Bone marrow smears from 107 patients with anemia over the age of 60 were detected by Wright-Giemsa staining and chemical marked CD41 Streptavidin-Alkaline Phosphatase (SAP) staining for the number and types of micromegakaryocytes, respectively. Results: The detection rates of megakaryocyte by the CD41 linked staining and Wright-Giemsa staining was statistically significant difference (P<0.01). Among which the group with MDS ranks the first, followed by ITP > MA > ACD > MM > IDA > RA, AA, PRCA, CAA; Detection rate of lymphoid micromegakaryocyte from the group with MDS was 73.6%, there were not observed in other groups by CD41 linked staining. Conclusions: CD41 linked micromegakaryocyte staining obviously increases the detection rates; which is valuable for differential diagnosis of anemia in the elderly.