Background: Anemia is a widespread public health concern affecting school-aged children, with implications for cognitive development, physical growth, and academic performance. India exhibits significant regional disparities in anemia prevalence, influenced by factors such as nutrition, socioeconomic status, and access to healthcare.

Objective: To compare the prevalence of anemia based on clinical signs among school-going children aged 10 to 15 years in selected urban and rural schools of Belagavi.

Methodology: This cross-sectional, observational pilot study was conducted in two schools—one urban and one rural—in Belagavi. A total of 406 students (150 urban, 256 rural) were clinically screened for signs of anemia, including pallor of conjunctiva, nail beds, skin, and breathlessness on exertion.

Results: Out of 406 students, 106 (26.1%) showed clinical signs suggestive of anemia—46 (31%) from the urban school and 70 (27.3%) from the rural school. Among urban students, 31 females and 15 males were found anemic, while in rural areas, 39 females and 31 males exhibited clinical signs of anemia. Overall, female students were more affected than males.

Discussion: Contrary to earlier regional studies which reported higher anemia prevalence in rural areas, this pilot study observed slightly higher clinical anemia in urban school children. Female students, irrespective of geography, were more commonly affected. The findings suggest the need for further investigation using hemoglobin estimation and potential homoeopathic interventions.

Conclusion: This pilot study highlights a notable prevalence of clinically diagnosed anemia in both urban and rural school children, with a higher proportion among females. Future interventional studies with laboratory-based diagnostics (Hb estimation) are recommended, along with school-based anemia management programs including homoeopathic support.