Objective To study the application of cell morphology in blood smear and automatic blood cell analyzer detection in blood routine examination.Methods A analys was was conducted on 180 patients with suspected Macrocellular anemia at Yishui County People's Hospital from February 2020 to February 2023.The positive detection rates of disease were statwastically analyzed for individual and combined tests,and the positive detection rates of toxic particles/vacuolar degeneration,nucleated red blood cells,and atypical lymphocytes were also statwastically analyzed for individual and combined tests,statwastical analyswas of diagnostic efficacy for individual and joint testing.Results The positive detection rates of monocytes,neutrophils,lymphocytes,basophils,and eosinophils detected by the combination of blood smear cell morphology and fully automated blood cell analyzer were higher than those detected alone(P<0.05).The positive detection rates of toxic particle/vacuolar degeneration,nucleated red blood cells,and atypical lymphocytes detected by the combination of blood smear cell morphology and fully automated blood cell analyzer were higher than those detected alone(P<0.05).The sensitivity,specificity,accuracy,and negative predictive value of the combined detection of blood smear cell morphology and fully automated blood cell analyzer were higher than those of individual detection(P<0.05).Conclusion The value of combined detection of blood smear cell morphology and fully automated blood cell analyzer in blood routine examination is higher,so is worthy of promotion.