A program for both preoperative collection and intraoperative salvage of autologous blood was established for a pediatric population. Eighty two patients, 16 years old or younger, participated during a 2-year period. Thirty four had blood collected preoperatively and 48 utilized salvaged blood only. Only 5 percent of preoperative donations were associated with any adverse reaction and all reactions were mild. Salvaged blood provided an average of 48 percent of all blood needs in those patients in whom it was used alone; in only 10 percent of cases did it provide for all of the patient's blood needs. Preoperatively collected blood met an average of 74 percent of blood needs when it was used alone; in half of the cases it was the only blood the patient required. The combination of preoperatively collected and intraoperative salvaged blood was highly successful, meeting an average of 94 percent of blood needs and supplying all blood needs in 77 percent of these patients.