Background: Blood transfusion is an indispensible part of modern-day health care and there is an increase in use of blood. National guidelines for use of blood and its components are often not followed in practice. Objective: To define the justified and appropriate use of blood and its components as a drug. Materials and Methods: We carried out cross-sectional study on patients requiring transfusion of blood and its components from January 2012 to June 2012. Tested blood (7048 units) and its components for 2742 patients were surveyed during a period of 6 months and the indications for usage and transfusion reactions associated with its usage were recorded. Result: Of the hospitalized patients, 11.82% received blood transfusion. A total of 7048 transfusions were performed in 2742 patients. Most of the blood transfusions were seen in age group of 18–50 years followed by ≤12 years. Blood transfusion was more common in males than in females, except in the age group of 13–17 years. Of the blood transfusions received, maximum were of packed red cell (47.15%) followed by those of whole blood (43.06%). Of 5154 components prepared, only 4353 were used. Single-unit blood transfusions were performed in 55.65% patients. Most common and rare blood groups were B+ and AB–, respectively. Maximum transfusions were performed among patients with anemia (877) followed by those with thalassemia (422) and those having bone fractures (306). Maximum transfusions were performed to children ward (765). Conclusion: This study reinforces the importance of justified and appropriate use of blood and its components in the clinical practice. Implementation of guidelines for use of various blood products may help in decreasing inappropriate use of blood and its components.