This study analyzed 48,000 samples from Nanded, Maharashtra, India to characterize the spectrum of hemoglobin disorders in the region. High performance liquid chromatography (HPLC) identified 2,742 cases of abnormal hemoglobin, including thalassemia major, sickle cell disease, sickle cell trait, and double heterozygous cases. The prevalence of sickle cell disease was 0.81% and thalassemia trait was 2.17%. Caste distributions of cases matched other local studies. Early detection of hemoglobin disorders through expanded newborn screening could help reduce disease burden through prevention and management strategies.