Abstract: Objective To investigate the clinical correlation between the degree of anemia and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with renal damage. Methods The clinical data of 120 AAV patients with renal damage diagnosed in the Affiliated Hospital of Xuzhou Medical University from January 2013 to June 2019 were analyzed retrospectively. All the patients were associated with anemia (anemia criteria: male Hb<120 g, female Hb<110 g/L). According to the level of hemoglobin, they were divided into three groups: Hb≥90 g/L group, 60 g/L≤Hb<90 g/L group and Hb<60 g/L group. The clinical characteristics of the three groups were compared, and the long-term prognosis of AAV patients with renal damage was analyzed. Results The time from onset to diagnosis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum albumin (Alb), serum creatinine (SCr), estimated glomerular filtration rate (eGFR) and 24 h urinary protein quantity in patients with different hemoglobin levels were statistically significant (P＜0.05). The mortality of patients in Hb<60 g/L group was higher than that in the other two groups (P＜0.01). The long-term renal survival rate was also statistically significant among patients with different hemoglobin levels(P＜0.01). Conclusions AAV patients with renal damage are often accompanied by anemia. Hb level can reflect the severity of the disease and predict the prognosis.