Background: Iron deficiency anemia (IDA) is the most common micronutrient deficiency in the world and almost a third of the world's population is involved with IDA. It even in mild type, could lead to serious disorders such as impairment of learning and mental focus. Reduction of iron resources results in an imbalance in the physiological function. With regard to the role of iron in myelination of neurons and the effect on nerve conduction velocity, iron deficiency could lead to changes in sensory and behaviors responses. Given the importance of anemia and IDA in girls' high schools of Ilam City, this study aimed to determine the prevalence of anemia and IDA. Methods: High school girls aged 16-18 years (n=210) were selected by random sampling design. Iron and total iron binding capacity (TIBC) was measured. Complete blood cells count and serum ferritin concentration also was assessed. Anemia and IDA was tested as different methods. Iron depletion (Id) and Iron deficiency (ID) was tested too. Results: According on the analysis of hematological and iron indices, subjects were affected to anemia (3.4 to 70.9%) and iron deficiency. Severity distribution of anemia was categorized as form of mild (28.5%), moderate (1.4%) and sever (0%). Iron depletion and Iron deficiency was found for 45.2 and 4.3% of study participants respectively. The correlation of hemoglobin (Hb) with ferritin (r=0.1, p= 0.15) and TIBC (r=-0.05, p= 0.4) was not significant. Independent relationship of hemoglobin concentration with MCV, serum ferritin and TIBC were significant. Conclusion: This study shows that the prevalence of anemia is high in student's girls from Ilam, Iran. Due to the prevalence of iron deficiency anemia in high school students, it is necessary that be given them proper nutrition program. In the long-term awareness of women's nutrition should be considered and should be taken to reform of their bad habits. Enrichment of food products with iron compounds should be considered as a national program. It should be checked also the role of economic status and parasitic diseases of participants in ID and IDA.