Two hundred and three elective orthopaedic procedures were performed in 193 children and young adults participating in an autotransfusion program in which they donated from one to three units of blood preoperatively, which were used to replace blood lost during surgery. One hundred and thirty-seven procedures, including ninety-one posterior spine fusions for scoliosis, were carried out with autologous blood only. The results of this study show that autotransfusion is a satisfactory method of blood replacement in children and young adults undergoing elective orthopaedic procedures.