Infants, particularly those who were very small premature neonates, are among the most common of all patient groups to undergo extensive transfusion. It is estimated that approximately 300,000 neonates undergo transfusions annually. Most infants who undergo transfusion are exposed to multiple blood donors, and although each exposure poses only a small risk, the potential for adverse effects of multiple transfusions is not variable, and based on scanty scientific information. For the most part, controlled scientific studies have not been performed to clearly establish the indications for the transfusion of blood components to neonates. Considering these limitations, guidelines are offered for the transfusion of red blood cells, platelets, and neutrophils into neonates.