Pernicious anemia (PA) is characterized by Vitamin B12 deficiency which arises due to lack of intrinsic factor as a result of autoimmune destruction of gastric body mucosa and loss of gastric parietal cells. Generally it is considered as a disease of the elderly as its prevalence is 0.1% in general population and 1.9% in subjects over the age of 60 years. Pernicious anemia in age group below 30 years is less common (<4%). Clinical presentation of Pernicious anemia is insidious and varied ranging from subtle anemia to serious neurological manifestations with a future risk of developing neoplastic changes in stomach. It is considered as a “great pretender” because of its wide spectrum of clinical manifestations. But once diagnosed treatment is easy with parenteral replacement and maintenance of cobalamin.