Abstract This article identifies the need for blood transfusions for the elective orthopaedic surgical patient, incorporating a brief review of the history surrounding blood transfusions in an attempt to gain an understanding of where we are today. It will critically review the use of homologous and autologous blood transfusions. Autologous transfusions will be described in more detail to give an insight into its available uses. Benefits as well as risks of both types of transfusion will be examined to acknowledge both the advantages and disadvantages for use. The nursing role in relation to blood transfusions will also be highlighted acknowledging where gaps in available research exist.