Background: Assessment of blood and blood components utilization is an important tool to rnreduce inappropriate transfusions and helps to show the frequency of blood and bloodrncomponent utilization, recipient status by pre- and post- transfusion assessments in additionrnimproved and not improved after transfusion. However in Ethiopia the regular audit andrnassessment of the transfusion practice is not well studied.rnrnObjective: To assess utilization of blood and blood components for transfusion at Black LionrnSpecialized Hospital, Addis Ababa Ethiopia.rnrnMethods: A one year (September 2009 to August 2010) hospital based retrospective studyrnwas conducted to analyze the pattern of blood component utilization in Black LionrnSpecialized Hospital blood transfusion service effected from October 2010 to Januaryrn2011.There were about 4,570 transfusion episodes and 10,836 units of blood were transfused.rnUsing estimation of single population proportion formula and systematic random sampling wernselected 373 subjects and collected information from the existing blood bank log book onrnABO and RH blood group, amount of transfusion episodes, and type of blood administered. Inrnaddition, data on sex, age, profession, level of education and department of the health worker,rntype of blood component, and amount of unit administered, prevalence of unexpectedrnreaction, pre- and post transfusion examinations including improvement status. Data wasrnanalyzed for descriptive statistics, univariate and multivariate analysis using SPSS versionrn15.0 software (SPSS INC Chicago IL, USA).rnrnResults: - Of 361 transfused study subjects 856 units of blood were transfused with the meanrnof 2.37 units. Of the transfused 188(52.1%) were Females. The most widely used blood andrnblood component type in this study was whole blood 307 (85%) and the combination of twornblood products were given to 27(7.5%). Plasma was transfused only for single patient (0.3%).rnThere were no transfusion reactions after transfusion. Out of the total none improved cases,rn45(66.2%) were those transfused with whole blood transfusion. The proportion ofrnimprovement after transfusion according to service ranged from 69.0% to 100%. When 95%rnCI for the adjusted odds ratios were calculated among these variables, significant associationsrnwere found between the overall improvement statuses of the patient with their profession ofrnthe health worker ordered the transfusion and type of blood and blood product administered.rnConclusion: - The overall utilization of blood and blood components were similar to otherrndeveloping countries. However, transfusion of blood components was very low and therernwere high rate of whole blood transfusion. The prevalence rate of patient improvement statusrnafter transfusion was high.