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Background and purpose: Throughout the world 5.2% of the population is carrier for a main hemoglobin disorder. Mazandaran province in North of Iran is highly influenced by heterozygote advantage resulting in high prevalence of hemoglobinopathies. Hemoglobin E is one of the beta globin variants that can cause severe anemia such as thalassemia major. Materials and methods: This descriptive study was carried out in 750 individuals (375female and 375 male) with microcytic hypochromic anemia (MCH<27, MCV<80) attending thalassemia counseling center in Babolsar, during 2006-2011. Hemoglobin electrophoresis and genetic tests were performed to determine the type of α, β or other rare forms of thalassemia. Results: Among the subjects 297 had high HbA2 and were classified as beta thalassemia minor carriers. There were 403 cases with normal HbA2 and 50 had excessive-Hgb band. In acidic electrophoresis and HPLC 20 people were found with HgbE band. To confirm the diagnosis DNA analysis was performed for 10 cases and Glu26 Lys (HgbE) was confirmed. Conclusion: This study showed high incidence of hemoglobinopathies in Mazandaran province. Therefore, it is important to evaluate the beta globin variants such as HgbE to prevent more thalassemia major in the region.