Background. Although blood ordering is a common practice in surgical field, the average requirement for a particular procedure is usually based on subjective anticipation of blood loss rather than on evidence based estimates. Overordering with minimal utilization squanders technical time, reagent and imposes extra expenses on patients. This study was conducted to assess blood utilization practices. Methods. Cross-sectional study was conducted in Gondar Hospital. Five-month data were collected from all discharged surgical patients and blood bank registries. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (%T), and transfusion index (TI) indices. Results. A total of 982 patients were requested to prepare 1,072 crossmatched units. Of these, 468 units were transfused for 286 patients. The overall ratios of C/T, %T, and TI index were 2.3, 47%, and 0.77, respectively. Blood transfusion from the units crossmatched was 43.6%. Moreover, the highest C/T ratio was observed in elective surgical patients. Conclusions. The overall blood utilization was encouraging, but excessive crossmatching with minimal transfusion practice was observed in elective surgical patients. Blood ordering pattern for elective procedures needs to be revised and overordering of blood should be minimized. Moreover, the hospital with blood transfusion committee should formulate maximum surgical blood ordering policies for elective surgical procedures and conduct regular auditing. 1. Introduction Blood transfusions play a major role in the resuscitation and management of surgical patients [1] and ordering of blood is usually a common practice in elective and emergency surgical procedures [2]. The preoperative request of blood units, especially in elective surgery, is often based on the worst case assumptions, demanding large quantities of blood or overestimating the anticipated blood loss, of which little is ultimately used [1]. This may cause exhaustion of valuable supplies and resources both in technician time, effort, and biochemical reagents. It also adds to financial burden for each patient undergoing a surgical procedure [3]. Increasing demand for blood and blood products together with rising cost and transfusion associated morbidity led to a number of studies that review blood ordering and transfusion practice [4, 5]. Since the introduction of blood transfusion into clinical practice, its appropriate use has been the subject for debate. It has been reported that only 30% of crossmatched blood is used in elective surgery [6]. In
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