INTRODUCTION:: Blood transfusions are commonly administered during gynecological surgery. Traditionally, multiple units of packed red blood cells (pRBC) were transfused simultaneously, with a goal hemoglobin level (Hb) of 10 g/dL. However, research shows that this is associated with worse patient outcomes. In 2015, Ochsner implemented restrictive transfusion guidelines to improve patient outcomes and reduce costs. This protocol recommends transfusing one unit pRBC at a time, with an Hb goal of 7 (8 g/dL in patients with acute coronary syndrome or who are symptomatic). A retrospective study was conducted to assess gynecologistsʼ understanding and adherence to these guidelines in academic versus community practices. METHODS:: IRB approval was obtained from the Ochsner Clinic Foundation. Gynecologists completed an anonymous survey assessing their knowledge of Ochsnerʼs transfusion guidelines. To evaluate adherence to the guidelines, a retrospective chart review was conducted on gynecologic surgeries that utilized pRBC transfusion in 2017. RESULTS:: Compared to 2016, awareness of Ochsnerʼs transfusion guidelines amongst practitioners (81.36% vs 72.7%) was increased. Knowledge of the guideline parameters also improved. 175 charts were reviewed from community (n=91), academic (n=53), and oncologic (n=31) sites. Academic sites adhered to guidelines more often than community sites (49% vs 31.8%, P<.017). The most common departure from the guidelines was transfusing multiple units of pRBC at once. CONCLUSION:: Although most practitioners were aware of Ochsnerʼs transfusion protocol, they violated these guidelines in practice. Despite overall knowledge of the guidelines, there continues to be a lack of adherence amongst providers. Further studies are needed to identify and address reasons for non-adherence.