In this study assessing the safety and value of the routine use of autotransfusion in elective aortic aneurysm surgery, the first 16 patients (control group) received homologous transfusion only, while the subsequent 38 patients (autotransfusion group) received a combination of predeposit and salvage autotransfusion (Solcotrans device). Between 1 and 3 units of blood were venesected preoperatively, and a median of 0.80 (0.20-2.75) litres of unwashed shed blood was salvaged and re-infused (48% of the measured blood loss). A median of 4 units of banked blood was required in the control group compared with 2 units in the autotransfused group, an average saving of 2 units per patient (P < 0.001). Banked blood was avoided completely in 37% of patients in the autotransfusion group. There were no haematological or biochemical complications. Predeposit and salvage autotransfusion is simple and safe, and reduces banked blood requirement in aortic aneurysm surgery.