Introduction: Pancytopenia is a fairly common hematological condition encountered in routine clinical practice. Since there is a wide variation in the etiologies of pancytopenia, even in different populations of the same geographical region, the identification of underlying etiologies is important. With this in mind, our study was undertaken to investigate the epidemiological and clinico-hematological profile of pancytopenic adults with the aim of identifying the different etiologies of pancytopenia. Materials and Methods: This is a retrospective study including all adult patients with pancytopenia admitted to the internal medicine department at Hassan II University Hospital in Fez, Morocco, from January 1, 2019 to December 31, 2022. Pancytopenia is defined by the simultaneous presence of a hemoglobin level < 13.0g/dL in men and 12.0g/dL in women, a total leukocyte count < 4.0 × 10^9 /L and a platelet count < 150 ×10^9 /L. Each patient included in the study underwent a series of investigations, including: blood count and reticulocyte count; peripheral blood smear examination; vitamin assays; bone marrow aspiration; immunophenotyping; osteomedullary biopsy (OMB) and serologies. Patients already diagnosed and under treatment, as well as patients under 18 years of age, were excluded from the study. Results: A total of 164 patients with pancytopenia were identified during our study period. The mean age of our patients was 48 years [extremes 18y-89y], with a preponderance of women (87women/77men). Mucocutaneous pallor was present in 100% of our patients, hepatosplenomegaly in 22.56% and hemorrhagic syndrome in 18.29%. Infectious syndrome and bone pain were observed in 12 patients (7.31%) and 05 patients (3.04%) respectively. Nineteen (19) patients had microcytic anemia, 85 had normocytic anemia and 60 patients had macrocytosis. Vitamin assays revealed vitamin B12 deficiency in 43 patients (26.91%), while 15 patients (9%) had folate deficiency. Combined B12 and folate def