Background: In infants and young children, severe chronic anemia may lead to delayed growthrnand long term effects on neurodevelopment and behaviour. The main causes of anemia are:rndietary iron deficiency; infectious diseases, deficiencies of other key micronutrients or inheritedrnconditions that affect red blood cells (RBCs). Iron deficiency accounts for about 50% of all casesrnof anemia which results in iron deficiency anemia (IDA). According to the Demography HealthrnSurvey, the prevalence of anemia among Ethiopian children under the age of 15 is estimated tornbe about 24%, classifying it as a moderate public health problem as identified by WHO. rnObjective: To investigate the effect of Helicobacter pylori and Helminths infection on anemiarnwith emphasis on ferritin level of school children in Batu town, Oromia Region, Ethiopia. rnMethods: A comparative study was conducted on 161 primary school children aged 4-14 years.rnSerum samples were collected for serum ferritin level measurement using Beckman Coulterrnchemistry analyzer. Secondary data on haemoglobin and RBC indices were extracted usingrnformat. SPSS version 21 was used to enter and analyze data. Statistical significance wasrndetermined between the groups using an independent t-test and a non-parametric Mann-WhitneyUrntestrnwithrnarnPrnvaluernlessrnthanrn0.05.rnrnResults: A total of 161 samples were analyzed in this study, with 77 (47.8%) of them beingrnmales. Of them, 109 (67.7%) were in the cases group, while 52 (32.3%) were negative for bothrnH. pylori and helminths. There was no statistically significant difference in serum ferritin levelsrnbetween H. pylori stool antigen positive or H. pylori antibody positive children compared withrnthe control groups, (P=0.787, P= 0.350) respectively. There was no significant effect on serumrnferritin as well as hemoglobin, RBC indices between helminths infection when compared with arncontrol group. The serum ferritin level (P=0.286), hemoglobin concentration (P=0.563), MCVrn(P=0.646), MCH (P=0.485), and MCHC (P=0.975) all increased as a result. rnConclusion and Recommendation: The presence of Helicobacter pylori or helminths has norneffect on serum ferritin levels or the development of iron deficiency. Cohort studies are rnrecommended for establishing a cause and effect relationship between H.pylori infection or rnhelminths infection and serum ferritin levels.