Abstract：Objective: To investigate the risk factors of iron deficiency anemia (IDA) in preschool children, and evaluate the clinical effect of individualized iron supplement intervention. Methods: A total of 186 preschool children with IDA treated from January 2023 to December 2024 were enrolled as the anemia group, and 186 healthy children receiving physical examination in the same period were selected as the control group. General data of all subjects were collected, and independent risk factors of IDA were screened by univariate analysis and multivariate logistic regression. Children in the anemia group were randomly divided into routine group and observation group, with 93 cases in each group. The routine group received standard oral iron supplementation, while the observation group received individualized iron supplement regimen. The clinical efficacy, iron metabolism indexes and adverse reactions were compared after 12 weeks of intervention. Results: Multivariate analysis showed that picky eating, complementary feeding initiated later than 6 months, maternal anemia during pregnancy, recurrent respiratory tract infection and low family monthly income per capita were independent risk factors for IDA in preschool children (P<0.05). After intervention, the total effective rate of the observation group was 94.62%, significantly higher than 80.65% in the routine group (P<0.05). Levels of serum iron, serum ferritin and transferrin saturation in the observation group were remarkably higher than those in the routine group (P<0.05). The incidence of adverse reactions in the observation group was 5.38%, lower than 16.13% in the routine group (P<0.05). Conclusion: Individualized iron supplementation formulated in accordance with clinical guideline recommended dose can effectively improve iron metabolism, enhance therapeutic effect and reduce gastrointestinal adverse reactions, which is worthy of clinical application.