Background: Chronic renal failure (CRF) is associated with a wide spectrum of hematological abnormalities, of which anemia is the most predominant. Red cell parameters provide a simple, cost-effective, and readily available means to assess the nature and severity of anemia in CRF patients not receiving renal replacement therapy (RRT). Objectives: To study red cell parameters in patients of chronic renal failure not treated with renal replacement therapy and to characterize the type and severity of anemia in such patients. Methods: This cross-sectional observational study was conducted over a period of 18 months. A total of 300 patients diagnosed with chronic renal failure not on renal replacement therapy were enrolled. Complete blood count (CBC) with red cell indices including hemoglobin (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and peripheral blood smear examination were analyzed. Data were statistically evaluated using SPSS version 26.0. Results: Anemia was present in 92.3% of patients. Normocytic normochromic anemia was the most common type (61.3%), followed by microcytic hypochromic anemia (22.7%) and dimorphic anemia (11.3%). Mean hemoglobin was 7.8 ± 1.9 g/dL. RDW was elevated in 68% of patients. A significant negative correlation was found between eGFR and severity of anemia (p<0.001). Conclusion: Red cell parameters are valuable tools in the evaluation of anemia in CRF patients not on RRT. Normocytic normochromic anemia is most prevalent, correlating with declining renal function.