Vitamin B12 deficiency anemia often leads to very different clinical findings, such as fatigue, dyspnea, loss of appetite, etc. The following case has been diagnosed with both vitamin B12 deficiency and autoimmune hemolytic anemia that have been presented with seriously hemolysis and pancytopenia. 35-year-old male patient who was Syria refugees and consulted with us due anemia and etiology of pancytopenia by internal medicine service has been admitted and examined by hematology ward. Vitamin B12 deficiency related megaloblastic anemia had been overlooked and after appropriate treatment had been administered clinical symptoms recovered. Both clinical cases should be kept in mind because AHA and vitamin B12 deficiency related megaloblastic anemia could be seen rarely.