Primary autoimmune hemolytic anemia (warm-reacting auto antibodies), may occur at any age and affects both sexes. The onset may be sudden or insidious. If the hemoglobin has dropped suddenly or to very low level and there is cardio-respiratory emborassment, patient would need a blood transfusion. And a close watch should be kept on urine output, also to keep the urine alkaline. Corticosteroid are the mainstay of treatment. The dose is 1-2 mg/kg/day. The hemoglobin has reached normal level, steroid are reduced 5 mg every week. If patient fails to respond to corticosteroids or the maintenance dose required for corticosteroids causes unacceptable side effects, methylprednisolone pulse therapy, alternative are immunosuppression therapy or splenectomy. As a life saving temporary need, plasmapheresis may be utilized to bring down the titre of antibodies.