This prospective study compared serum ferritin and bone marrow trephine iron studies with the results of bone marrow aspirate Perl’s stain in consecutive adult patients presenting at the haematology ward and requiring marrow studies. Sixty patients, 35 males (58%) and 25 females (42%), with a mean age of 44 ± 4 years were recruited into the study. Thirty-four (56%) of the patients had human immunodeficiency virus (HIV) infection while the remaining 26 had chronic myeloid leukemia (CML), non-Hodgkin’s lymphoma (NHL), severe anaemia or hyperreactive malarial splenomegaly (n = 13, 7, 4 and 2 respectively). Full blood counts (FBC), red cell indices, ESR, blood film microscopy (for malaria parasites and blood cells morphology), ELISA-based serum ferritin concentration (sFC) and bone marrow aspiration (and trephine biopsy, if aspirate is aparticulate) were done. All parameters were analysed for correlation to the Sfc values and a p-value < 0.05 was considered significant. There was no statistical difference in the sFC of patients analysed according to age, sex, diagnosis, or ESR. However, the sFC of anaemic patients (PCV ≤30%) were significantly higher than those of the non-anaemic. Also, the difference in the sFC of (bone marrow) aspirate-negative and aspirate positive patients was significant; and further enhanced with ESR adjustment of the sFC. Bone marrow trephine biopsy iron studies correlated acceptably with aspirate Perl’s stains in 78% of cases and helped to diagnose iron adequacy in 31% ofpatients with hypogranular aspirates. The study has shown a clear correlation between serum ferritin values and bone marrow studies; and the possibility of enhancing its predictive value with an ESR in patients with inflammatoryconditions and malignancies.