Objectives: Evaluation of the compact benchtop Erytra Eflexis ® automated analyser was performed at three health centres representing a range of routine transfusion workload.Background: Automation instruments with the simplicity and flexibility adequate for small-to mid-sized blood transfusion services are an unmet need. Methods: Performance in pre-transfusion testing (2109 ABO/D, 382 Rh/K phenotype, 2001 antibody screening, 113 antibody identification, 151 DAT, 88 extended phenotype; 655 cross matching) in comparison to Erytra ® as reference device was assessed. Throughput [time to first result (TTFR), final turn-around time (TAT), processing rate] was calculated; usability and adaptability in laboratory practice under routine and with emergency samples were surveyed.Results: Agreement between systems was 99·8% (11/5499 test discrepancies, all due to weak/doubtful positive reactions). Erytra Eflexis produced six true positives (two Rh/D, two B positives, two screening), four false positives (three screening and one cross matching) and one false negative (screening). Processing of eight routine samples with the Erytra Eflexis for ABO/Rh(D) and screening took 34-38 min and 32-37 min, respectively, independent of the simultaneous processing of a STAT sample, whether or not the incubator for STAT was reserved. In this scenario, a STAT sample requested within 2 min after the routine load was processed in 14-26 min. Processing rate tended to stabilise and optimise in the larger workloads, particularly in ABO/Rh(D)/K cards (16·7, 18 and 19·5 results/h for 10, 15 and 24 specimens, respectively). Conclusion:Erytra Eflexis analyser was found to be reliable and suitable for pre-transfusion routine tests performed in a small-/medium-sized blood transfusion laboratory.