The higher incidence of chronic kidney disease (CKD) has currently become a worldwide and major public health problem. Many complications associated with CKD patients greatly influence their hospitalization rate, quality of life and survival rate. Anemia is a common complication of CKD, and is an independent risk factor for cardiovascular and cerebrovascular complications in CKD patients. Longstanding anemia will cause heart overload, left ventricular hypertrophy, heart failure, higher hospitalization rate, and increased mortality rate. Indoxyl sulfate (IS) is an important protein-bound uremic toxin, accumulating in the body at the early stage of CKD. IS promotes the progression and complications of CKD through various pathways. Here we focus on the role of IS in renal anemia based on the recent studies that IS may also be involved in renal anemia.