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Objective: This study analyses the impact of weekly iron supplementation with ferrous sulphate heptahydrate (FeSO4) in 5-year-olds compared with placebo, on hemoglobin (Hb) and hematocrit (Ht) values and anemia. Design: The study concerns a cluster-randomized, placebo-controlled double-blind trial. Intervention participants received 50 mg elemental iron for 14 weeks. Setting: The study population comprised pre-school children (n = 135) from one randomly chosen public school in the northeast of Brazil. Subjects: Participants were 5-year-old students from a public school. Results: Mean Hb and Ht values increased after iron supplementation, with p < 0.0001. There was no statistically significant increase in the placebo group. After intervention, anemia prevalence reduced only in the intervention group, from 48.0% to 26.0%. Conclusions: Weekly iron supplementation was effective in reducing anemia in 5-year-olds.