Pernicious anemia is thought to be rare in Africa, with the biggest burden of anemia cases attributed to the neglected tropical diseases (NTDs), Malaria and HIV . However some reports have reported pernicious anemia to be the commonest cause of megaloblastic hemopoiesis in an African context. In the same study, isolated folate deficiency was noted to be rare. Pernicious anemia needs prompt diagnosis to avoid long-term sequelae of the condition . However this is not the case, more so in resource limited settings due to a multiplicity of factors which include low index of suspicion, concurrence with microcytic anemia and high costs of workup. The two reported cases demonstrate this and hopefully will enhance our diagnostic capability of this rather debilitating condition if treatment is delayed.