Background: Rational blood use have always been a challenge in the medical practice. Rational blood use is important to lessen the demand for blood products and to transfuse blood only when necessary . Objectives: To determine the rational and irrational use of specific blood product/s as to age, gender, indications of transfusion and department-in charge, to establish the percentage of blood products used as to blood type and to describe the transfusion reactions/complications. Methods: This is a cross-sectional study on the rational use of blood products conducted in a 700 bed capacity tertiary hospital. This study aimed to evaluate the compliance to rational use of blood products. Results: Pre-school age has the highest rational use (86%) while Neonates has the highest irrational use (87). Males had the highest rational use (70%). Cryoprecipitate had the highest rational (100%) use while Whole Blood had the highest irrational use (85%). Pediatrics had the highest rational use (80%) while EENT had the highest irrational use (83%). PRBC was the most requested blood product and Type O was the most requested blood type. Transfusion reactions was 3%. Conclusion: The rational and irrational use of blood products in pediatric patients was significantly associated with factors such as the patient's age, indication for transfusion as to blood product used, and department in-charge which can significantly influence the appropriateness of blood product use except for sex. A significant association exists between the percentage of blood products used and blood type and the likelihood or occurrence of transfusion reactions/complications.