The advent of AIDS has raised a concern regarding transfusion transmitted diseases. Blood transfusion is safer than ever before through continued improvements in safe donor recruitment, screening of donors, testing of donated blood and appropriate clinical use of blood. The risk of residual infections is further reduced through inactivation of pathogens in blood components. Prevention of technical and human errors in blood grouping, avoiding bacterial contamination of blood components and using leuco-depleted products to minimize immunomodulatory effects also increase blood safety. For safety, efficiency and effectivity it is necessary to improve clinical transfusion practices through alternatives to traditional hemotherapy such as autologous transfusion and audit of blood utilization practices by hospital transfusion committees.