Background: This review aims to critically evaluate the therapeutic potential of nanoparticle-based technologies for anaemia management and to discuss the biological mechanisms underlying their clinical and experimental efficacy.

Methods: A comprehensive narrative review was conducted using the PubMed, Scopus, and Web of Science databases to identify relevant publications published between 2010 and 2025. Searches incorporated standard medical keywords, including anaemia, nanoparticles, iron supplementation, targeted drug delivery, and haematological therapies. Eligible studies included preclinical investigations, animal experiments, and relevant review articles. Data were extracted systematically and synthesised through qualitative thematic analysis.

Results: The available evidence indicates that iron-based nanocarriers, iron oxide nanoparticles (including Fe₃O₄ nanoparticles), nanocapsules, and targeted nanoscale delivery systems substantially improve intestinal iron uptake, increase bioavailability, enable sustained drug release, and reduce gastrointestinal toxicity. These improvements are consistently associated with favourable changes in major haematological indices, including haemoglobin concentration (Hb), red blood cell (RBC) count, and serum ferritin levels. Furthermore, several advanced nanoplatforms possess antioxidant and anti-inflammatory properties that support erythropoiesis by attenuating oxidative stress, suppressing inflammatory mediators such as C-reactive protein (CRP), and protecting bone marrow function. Some multifunctional nanosystems have also demonstrated potential applications in gene therapy and diagnostic imaging. Nevertheless, not all nanoparticles exhibit favourable biological profiles. Certain materials, including titanium dioxide nanoparticles and specific iron oxide formulations, have been associated with oxidative stress, genotoxicity, and undesirable systemic toxicities.

Conclusion: Nanoparticle-based drug delivery systems represent a promising therapeutic strategy for anaemia by improving iron transport, enhancing bioavailability, and reducing treatment-related adverse effects. Despite these encouraging findings, concerns regarding cytotoxicity, oxidative damage, and the genotoxic potential of selected nanomaterials remain important challenges. Therefore, rigorous preclinical investigations together with well-designed clinical trials are essential to establish the long-term safety, efficacy, and clinical applicability of these emerging nanotherapeutic technologies.