Background <p>Preoperative anaemia is common, seen in about one-third of patients undergoing elective surgery. The most typical cause of anaemia globally is iron deficiency. Anaemia is linked to an increased risk of mortality, acute kidney injury, and postoperative infection. Intraoperative blood loss worsens pre-existing anaemia and increases the risk of allogeneic blood transfusion. This study aims to determine the following: (1) the prevalence of iron-deficiency anaemia (IDA) and non-anaemic iron deficiency (ID) among orthopaedic oncology patients planned for surgery in our centre and (2) the rate of red cell transfusion among these patients.</p> Methods <p>Patients aged 18&#xa0;years and above admitted to the Orthopaedic Oncology Unit who had preoperative full blood count and iron studies were recruited into the study. The study recruitment period was from October 2019 until October 2020. One hundred forty patients were included in this study.</p> Results <p>From this study, the prevalence of IDA among orthopaedic oncology patients planned for surgery was 10.7% and 36.6% of all anaemias. The prevalence of non-anaemic ID among all patients was 24.3%. 17.1% of all patients received blood transfusions, with an average of 1.9 units of red cells transfused per patient. Among anaemic patients, 39.0% received a blood transfusion, and 12.2% of those transfused had IDA. 8.1% of non-anaemic patients received blood transfusions.</p> Conclusions <p>Orthopaedic oncology patients with iron deficiency may benefit from preoperative optimisation of iron stores and Hb levels to reduce perioperative red cell transfusion and its associated risks and complications.</p>