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A low RDW (below 10.2%) means that the red blood cells vary very little in size. One reason for a low RDW level is macrocytic anemia. Another cause of a low RDW level is microcytic anemia. In these two disorders the red blood cells do not vary much in size because they are either all small or all large.
In combination with MCV, RDW is useful in diagnosing conditions such as anaemia of chronic disease, sickle cell beta thalassaemia, aplastic anemia and chronic liver disease to name but a few. This is discussed in more detail below. High RDW, Low MCV: Iron deficiency anemia, sickle cell beta thalassaemia. Normal RDW, Low MCV: