Thyroid hormones mediate the biological activities of almost all organ systems in the body. Patients with a deficiency of these hormones may present with a wide spectrum of clinical symptomatology. This report is of an infant who presented with chronic anaemia which was found to be secondary to hypothyroidism associated with a hypoplastic lingual thyroid gland. Physicians need to be alert to the varied manifestations of hypothyroidism so as to avoid delay in diagnosis and treatment.