Objective To study the application of cell morphology inblood smear and automatic blood cell analyzer detection in blood routineexamination. Methods A analys was was conducted on 180 patients withsuspected Macrocellular anemia at Yishui County People’s Hospital fromFebruary 2020 to February 2023. The positive detection rates of diseasewere statwastically analyzed for individual and combined tests, and thepositive detection rates of toxic particles/vacuolar degeneration,nucleated red blood cells, and atypical lymphocytes were alsostatwastically analyzed for individual and combined tests, statwasticalanalyswas of diagnostic efficacy for individual and joint testing. Results The positive detection rates of monocytes, neutrophils,lymphocytes, basophils, and eosinophils detected by the combination ofblood smear cell morphology and fully automated blood cell analyzer werehigher than those detected alone $\left({P<{0.05}}\right)$ . The positive detection rates of toxicparticle/vacuolar degeneration, nucleated red blood cells, and atypicallymphocytes detected by the combination of blood smear cell morphologyand fully automated blood cell analyzer were higher than those detectedalone $\left({P <{0.05}}\right)$ .The sensitivity, specificity, accuracy, and negative predictive value ofthe combined detection of blood smear cell morphology and fullyautomated blood cell analyzer were higher than those of individualdetection $\left({P<{0.05}}\right)$ . Conclusion The value of combined detectionof blood smear cell morphology and fully automated blood cell analyzerin blood routine examination is higher, so is worthy of promotion.