Homologous blood transfusions have associated infectious and immunological risks. Since 1989 the authors have conducted predeposited autologous blood transfusions (PABT) for infants and children in whom transfusions were expected to be required during an elective operation. Autologous blood was deposited in 13 patients ranging in age from 9 months to 10 years (median, 21 months) with weight from 7.3 kg to 33.6 kg (median, 10.5 kg). They included eight patients with Hirschsprung's disease, three patients with benign tumors, and two others. The volume of predeposition was calculated to maintain the patients' hematocrit at 30% after collection. Blood was deposited once or twice, 1 to 2 weeks before the operation. The actual volume of predeposited blood was 19.1 +/- 2.4 mL/kg in infants with Hirschsprung's disease, 21.8 +/- 10.0 mL/kg in children with Hirschsprung's disease, and 12.6 +/- 2.2 mL/kg in children with other diseases. Nine patients were operated on using only PABT, 2 patients required homologous blood transfusions in addition to PABT, and 2 patients did not require any blood transfusions. No complications occurred as a result of PABT except preoperative anemia. PABT is a safe and effective means of procuring blood for intraoperative transfusions in infants and children undergoing major elective general pediatric surgical procedures.