Increasing concern about the safety of transfusions and a desire to balance blood supply and blood needs stimulated a regional blood center to study the utilization of blood, rather than simply looking at distribution. A comprehensive survey of transfusion use, including packed red cells (RBCs), fresh-frozen plasma (FFP), and platelets (PLTs), was conducted in 12 Central Virginia hospitals. The medical records of 2579 transfused patients showed that the principal diagnoses in 23 percent of patients involved diseases of the circulatory system and those in 16 percent involved neoplasms, as classified under the diagnosis-related groups. Sixty-six percent (n = 1691) of patients had some type of surgery, with surgical patients overall using 1.9 times as many units of blood (RBCs, FFP, and PLTs) as nonsurgical patients. Mean patient age was 61 years, and the male:female ratio was 48:52 percent. This descriptive analysis of regional blood utilization has facilitated planning for local blood needs, provided indicators for areas of largest blood use, and given this region and others baseline data for future comparison.