Iron is essential for the synthesis of hemoglobin in erythrocytes and its deficiency can causes Anemia. An estimated 1.62 billion people are suffering from Anemia worldwide with its highest prevalence in developing countries specially India. Therefore, Government of India has started a strategic nutritional and weekly iron folic acid supplementation (WIFS) program to reduce its prevalence and severity among Indian women and adolescent girls. WIFS supplementation mainly includes either sugar coated ferrous sulfate (red tablet) or enteric coated ferrous sulfate tablets (blue tablets) as a prime dosage form to serve the people. Comparing these two dosage forms, conventional oral preparation of Ferrous Sulfate (sugar coated tablets) can cause dose related gastrointestinal side effects such as nausea, constipation, anorexia, heart burn, vomiting, diarrhea and approximately 25% of patients experiencing these side effects, whereas, there is some evidence that enteric-coated or delayed release Ferrous Sulfate preparations may reduce these gastrointestinal discomforts and could be more effective considering absorption of iron along the entire intestine, primarily in the duodenum and the jejunum, but, several reported case studies have been published so far which dictated that dissolution of iron formulation in acidic media such as gastric juice helps in its absorption and indicating better treatment outcomes with sugar coated tablets. Moreover, by passing the dissolution of iron tablets in gastric juice via enteric coating may results in its poor absorption. Hence, efficacy of iron supplement is being compromised at cost of safety (to avoid side affects) by formulating into enteric coated tablets. This review will focuses on information on burden of Anemia in India and various reported case studies which showed that sugar coated ferrous sulfate tablets might not be interchangeable with enteric coated ferrous sulfate tablets with compromised efficacy.