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Objective: To determine the frequency of pancytopenia among patients with vitamin B12 deficiency in a tertiary-care hospital, in Peshawar. Materials and Methods: A descriptive cross-sectional study was carried out at the Department of Hematology, Hayatabad Medical Complex, Peshawar from 18/4/2021 to 18/10/2021. In this study, a total of 252 patients were observed. From all patients, a sample of venous blood was obtained and sent to the hospital laboratory for the peripheral smear examination. Pancytopenia was diagnosed based on a peripheral smear showing Hemoglobin below 10g/dL, Total leukocyte counts less than 4,000 cells per mL, platelets count less than150,000 cells per mL, and reticulocyte count <2%. All the peripheral smears were done by an expert hematologist. Strictly exclusion criteria were followed to avoid cofounders and make the study results clear of any bias. Results: In this study mean age was 42 years with a standard deviation of ± 15.84. Thirty-eight percent of patients were males and 62% of patients were females. Moreover, 5% of patients had pancytopenia and 95% of patients didn't have pancytopenia. Conclusion: The frequency of pancytopenia was 5% among the local patients with vitamin B12 deficiency. [ABSTRACT FROM AUTHOR]