Background: This study aimed to investigate the effects of adding sprouted barley in the diet of lambs on growth performance, digestibility, nitrogen utilization, hematological and biochemical blood parameters and economic evaluation over 75 days. Methods: Thirty-six healthy 3-month-old Awassi lambs were used in this experiment. All lambs were individually divided into four dietary treatments with nine lambs each (T1 to T4: lambs receiving 0%, 25%, 50% and 75% sprouted barley as a replacement for the traditional diet, respectively). The growth performance, dry matter intake and dry matter excretion were assessed. The digestibility of the ingested dry matter and nitrogen, nitrogen balance, blood health markers, hematological and blood biochemical and economic evaluation were estimated. Result: Lambs fed T3 had a lower body weight on day 75 than those fed the other dietary treatments, with weight gain also being reduced for those fed sprouted barley during both the 45-75 and 1-75 day period. Feed intake generally increases with the sprouting of barley, resulting in a higher feed-to-gain ratio. White blood cell count and hemoglobin concentration reduced in lambs receiving T3 and T4. Total protein, globulin, triglyceride and glucose levels decreased in lambs receiving T3 and T4, whereas total cholesterol and HDL increased. Urea and ALT levels were lower in lambs fed sprouted barley. Sprouted barley had the highest dry matter content and nitrogen digestibility. Economic evaluations, including the profit rate, relative economic efficiency and investment rate, were higher. Overall, this experiment suggests that sprouting barley at 25% (T2) had no negative effect on the hematological and blood biochemical parameters of lambs, whereas economic evaluation indicators were higher at T2. The inclusion of sprouted barley resulted in the highest nitrogen balance and digestibility of dry matter and nitrogen. However, its effects on growth performance require further investigation.