Background: Predicting future blood requirements and optimizing current transfusion practices require information on blood product utilization. Objectives: The aims of this study was to determine the utilization patterns of blood components in Zahedan, the capital city of Sistan and Balouchestan province in southeastern Iran. Methods: This descriptive study was conducted from March to August 2015. Blood bank data were collected from seven hospitals. Moreover, the archived blood request forms were studied for the demographic data of blood receivers. Results: Overall, 13,312 blood request forms (30,418 requested blood units) were studied. The mean age of the recipients was 24.3 ± 20 year and 38.9% of them were of the O blood group, followed by B (28.8%). Packed cell (PC) units were the most commonly used products (36.7%), followed by leuko-reduced red cells (25.4%), fresh frozen plasma (FFP) (16.8%), platelets (15.2%), cryoprecipitate (3.2%), and washed red cells (2.5%). The major users of blood components were the thalassemia wards (38.7%). Among the blood components, the highest wastage was related to PC with 32.3%, followed by FFP with 22.5%. The highest rate of wastage was recorded in the surgery (1,081 units) and emergency (784 units) wards for PC products and CCUs (376 units) and ICUs (167 units) for FFP products. Conclusions: A high rate of blood wastage was observed in the use of PC and FFP units. Increased awareness of physicians and medical students leads to proper blood consumption in the future. The Hospital Blood Transfusion Committee should review blood transfusion guidelines to optimize blood consumption.