The Jehovah's Witness religion is a Christian movement, founded in the US in the 1870s, with 6 million members worldwide (150,000 in the UK). Members of this faith have strong beliefs based upon passages from the Bible that are interpreted as prohibiting the ‘consumption’ of blood. Their beliefs prevent them from accepting transfusion of whole blood or its primary components. They also believe that blood that has been removed from the body is ‘unclean’ and should be disposed of. The use of procedures that involve the removal and storage of their own blood are often unacceptable (Table 1).Blood-free major surgery in the Jehovah's Witness patient presents a challenge to the anaesthetic and surgical team. The problems associated with their management highlights a growing health-care issue – the supply, safety and appropriate use of blood products. Techniques learnt from treating them may prove beneficial to all patients undergoing major surgery. [ABSTRACT FROM AUTHOR]