In this study we have correlated the presence/absence of rare red blood cells with HbH inclusions with the alpha-globin genotype in a group of Sardinian alpha-thalassemia carriers, whose genotype have been defined by alpha-globin gene mapping. We found that the majority of the carriers investigated, including those with the deletion of a single or two alpha-globin genes and those with non-deletion lesions, have rare blood cells with inclusions, with no significant difference in the frequency of positive finding related to the alpha-globin genotype.