<p>BLOOD TRANSFUSION in the UK is a very safe procedure which, when used appropnately, will save lives or improve the quality of life in a large range of clinical conditions. Nevertheless it is widely recognised that, as in any other clinical intervention, there are a number of risks associated with this therapy. Healthcare professionals and the general public consider the possibility of transmission of infectious disease to be the greatest threat from the transfusion of blood and blood components. The second annual report from the Senous Hazards of Transfusion (SHOT) Scheme, however, emphasises that by far the greatest risk related to blood transfusion is human error (Williamson et al 1999). All staff involved have a vital role to play in assuring that the transfusion process is earned out professionally, with particular emphasis on correct identification of the patient and product at all times. A number of immunological complications of transfusion have also been reported and, while many of these are currently not preventable, rapid recognition and appropriate management may reduce the severity of morbidity and save lives. This report summarises the findings of the second annual SHOT report and examines the role of nursing staff in improving transfusion safety.</p>