Autologous blood transfusion, as an alternative to homologous blood, must be considered for those patients who require blood. Transfusion in gynecologic oncology surgery is often required and autologous blood transfusion has been utilized. Between January 1988 and December 1992 a total of 162 surgical procedures for gynecologic cancers were performed in the same number of patients. Of these only 102 were eligible for autologous blood transfusion as predonation. The mean age of patients was 57.8 years (range 35-81). Forty-three patients were affected with endometrial carcinoma, 31 with carcinoma of the cervix, 21 with ovarian carcinoma and 7 with vulvar cancer. Collected autologous blood units were 138 (mean 1.35 every patient). Indications for predeposited blood transfusion was given by a hemorrhage greater than 100 cc intraoperatively or hemoglobin level less than 10 g/dl until 1988 or less than 8 g/dl since 1989. Forty-eight (34.8%) of the collected units were transfused to 39 autologous donors (mean 1.2 units every patient). There was a significant difference in transfusion rate in patients: endometrium 25.8%, ovary 28%, cervix 45%, vulva 72.7%. Unused autologous blood units were discarded at the expiration date: they were 90, 65% of collected ones. In 6 patients homologous blood was necessary other than autotransfusions. Our experience demonstrates that the transfusion requirement in gynecologic cancer surgery depends on pattern of neoplasm and consequently of surgical procedure. Patients with carcinoma of the cervix and vulva are at risk for transfusion and have appropriate indications for autologous donation.(ABSTRACT TRUNCATED AT 250 WORDS)