Pallor is a clinical sign of anaemia. The severity depends upon the amount of pinkness of palm. It is graded as mild, moderate and severe. In children younger than 2 years palmar pallor, has a sensitivity of 58%, and the highest sensitivity to detect moderate anemia as compared to other anatomic sites. If the palmar creases are pale it indicates severe pallor. The common causes of severe pallor are haemorrhage, haemolysis ,aplastic anaemia and shock.