Objective To investigate the incidence of anemia and related factors in critically ill patients in Xinjiang Uygur Autonomous Region of China, in order to explore quality improvement strategies for the diagnosis and treatment of anemia in critically ill patients in the region. Methods A cross-sectional survey was conducted in the 77 ICUs in Xinjiang Uygur Autonomous Region, China, from January 31, 2024 to February 28, 2024. All critically ill patients admitted to the ICU during the study period were included in the screening, and patients were rescreened by the clinical expert team for analysis. Results A total of 727 patients were admitted to the ICU during the survey, and 686 patients were included in the analysis, including 272 male patients(39.7%). There were 413 patients(60.2%) with anemia. Variables with P<0.05 were determined by a clinical expert panel and included in multivariate logistic regression analysis and demonstrated that hospital grade(secondary hospital), age, weight, tumor disease, hematological disease, creatinine was associated with anemia in these patients(P＜0.05). The 28-day mortality rate of these patients was 28.3%, significant statistical differences were revealed in the vital signs, laboratory test results, and treatment between the deceased patients and surviving patients. Multivariate COX regression analysis demonstrated that body temperature(HR=1.310, 95%CI［1.014, 1.692］, P= 0.039) and white blood cell count(HR=1.052, 95%CI［1.019, 1.086］,P= 0.002) were independent risk factors for the 28-day mortality rate in critically ill patients with anemia. Conclusion Anemia is common in critically ill patients at all levels ICU in Xinjiang, which is characterized by high mortality rate. Individualized assessment of the cause of anemia and disease status of patients, improvement of diagnosis and treatment processes, and formulation of targeted prevention and treatment strategies are important directions for future special training and clinical research in critical care medicine in this region