Pernicious anaemia (PA) is a gastroenterologically defined autoimmune disorder. The atrophic gastritis leads to loss of intrinsic factor (IF) secretion, cobalamin malabsorption and ultimately megaloblastic anaemia and neuropathy. The discovery of cobalamin and IF in the 19th century turned this once-fatal disease to an eminently treatable one. PA affects all race being most prevalent in Northern Europeans. Chinese data remain scarce. Part 1 of the book contains an overview on history of PA, diagnostic pitfalls, challenges, from West to East, past to present, and a literature search (English: 1930–2008; Chinese: 1994–2008) on PA in Chinese population. In Part 2 of the book, the author describes a clinical cohort of 300 definite PA patients in a regional hospital whom she personally followed up from 1994 to 2010. With the global withdrawal of Schilling test in 2003, the author advocates a confirmatory test to be developed for IF antibody-negative PA cases, which account for 40% of the total cohort (215/548). The book contains useful information for clinicians and scientists in the fields of haematology, neurology, gastroenterology, geriatrics, immunology, nutrition and epidemiology.