The use of 534 units of fresh-frozen plasma (FFP) during 160 transfusion episodes in 135 consecutive patients was reviewed. Only 27 percent of transfusions were indicated by a need for replacement of labile coagulation factors. Other uses included volume repletion (31%), intraoperative bleeding or massive transfusion without coagulopathy (19%), and miscellaneous indications unrelated to labile coagulation factors (23%). Data from other institutions and national sources support the hypothesis that much of the increase in FFP use over the last decade is related to decreases in whole blood availability rather than to use for labile coagulation factor replacement. The use of FFP and red cells as a substitute for, or in preference to, whole blood may have significant adverse implications in terms of the cost and safety of blood transfusion.