This research determined the pattern and indices of blood usage, and the relationship between elective gynecologic surgeries and utilization of allogeneic red blood cell units in a tertiary retained hospital in Cebu City, Philippines. All patients who underwent elective gynecologic surgeries admitted from October 1, 2008 to December 31, 2008 were included in this study. This 3-month study utilized a descriptive-correlational research design. A total of 63patients underwent elective gynecologic surgeries during the study period. A total of 150 red blood cell units were ordered, but only 142 units were procured. All units were cross-matched but only 52 units were transfused. The overall frequency of blood transfusion related to elective gynecologic surgery was30.37%. This meant that 69.63% of the blood was not utilized. Ten patients seeded preoperative transfusions because of preexisting anemia, eight because of excessive bleeding during surgery, and nine had postoperative transfusions. The overall cross-matched/transfusion ratio of 2.73 revealed insignificant blood utilization. However, the probability of transfusion of 31.74% and the index of transfusion of 0.86 were indicative of significant utilization. There was inefficiency in the ordering of allogeneic red blood cell units in elective gynecologic surgeries. However, there was an appropriate number of units ordered for the patients. Moreover, a pre-operative cross-match was required for the procedure. Lastly, the type of surgery was not a determinant in the blood utilization.