ObjectiveTo optimise collection of sufficient autologous blood for elective surgery.MethodsProspective study of 40 patients referred for donation of autologous blood, who were booked for elective orthopaedic surgery in the period August 1992 ‐ September 1994. Patients received recombinant erythropoietin (r‐EPO) to stimulate erythropoiesis, and sufficient iron by injection so that iron deficiency did not limit the bone marrow response to the r‐EPO.ResultsThirty‐eight of the 40 patients treated with this protocol stored an average of 3.7 units each on a twice‐weekly donation schedule. Only one patient required supplemental homologous blood (two units) in subsequent surgery. One patient developed persistent hypotension, and one a late reaction to parenteral iron (which was controlled with corticosteroids). There were no other adverse events.Conclusionsr‐EPO in combination with parenteral iron is a safe and effective method of ensuring the collection of optimal amounts of autologous blood before surgery.