The increase in intensive treatment for cancer has impacted blood product transfusion practices. Transfusion guidelines are primarily institution specific, but the general concepts and theories are universal. Blood product screening has decreased the risk of transfusion-acquired infections; however, the risk is not obsolete. This article reviews current approaches to platelet, white blood cell, and red blood cell transfusions, as well as risks associated with these therapies (e.g., infection and transfusion-associated graft-versus-host disease). Pertinent laboratory studies, patient assessment, blood product administration, and patient education is discussed. The current approaches to platelet, white blood cell, and red blood cell transfusions are constantly changed and evaluated. Pediatric oncology nurses must stay up to date with these changes to provide optimal patient care.