This report summarizes the need for changes in certain areas of transfusion practice that may have some beneficial effect in improving transfusion safety and reducing the ever increasing demand for the use of red blood cells. These dual objectives can be achieved through a continuous educational and quality awareness program, encouraging the use of other available alternatives, including implementation of transfusion triggers reducing hemoglobin values, increased application of peri-operative/post-operative blood salvage, introduction of improved additive solutions and apheresis double dose RBC with a standardized hemoglobin content per unit; and changes in the clinical/laboratory practices, in particular when preparing patients for surgery. It is only through continuous education integration of better diagnosis/development/research and clinical practices in targeted patients that one can anticipate making a true contribution to the plodding and controversial issue of predicting transfusion safety and the cost benefit value of alternative strategies for transfusion. The current opinions on "safer transfusion" through the use of currently available alternatives are highlighted with the goal of promoting the use of transfusion alternatives in everyday clinical practice.