The occurrence of different types of hemoglobin variants in India has been well-documented in urban populations and in certain tribal areas. Beta-thalassemia and hemoglobins D, E, H, S, and rare variants like Hb Lepore, have been found in varying percentages. There is a higher incidence of Hb E in the Eastern region and of Hb D in certain Northern populations. The association of Hb E with beta thalassemia G6PD deficiency has been established. The relationship with other environmental factors, like malaria, is not yet clear.