Over a nine-year period extending from January 1986 to December 1994, eighteen cases of pernicious anemia occurring in Arabs were diagnosed at King Khalid University Hospital in Riyadh. There were 12 Saudi Arab patients and 6 non-Saudi Arabs. There were 11 males and 7 females. The mean age at presentation was 51 years. The presenting symptoms, laboratory features and the disease pattern were similar to those described in northern European patients in most respects with two possible exceptions. First, the mean age at presentation was lower and second, there was a higher frequency of the antibody to intrinsic factor than previously described in northern Europeans. Both differences have been previously noted in Blacks. Associated autoimmune diseases were identified in two patients, one of whom had diabetes mellitus and vitiligo while the other had a remote history of Graves' disease. One young female patient with primary infertility successfully conceived shortly following the initiation of appropriate cyanocobalamin therapy.