Background: Blood transfusion is an essential supportive therapy, used over a wide variety of clinical circumstances. Patterns of blood transfusion in pediatric patients are less characterized, and in Yemen information is chronically lacking. This study was aimed to assess the use of blood transfusion in children at a single center in a low resource setting. Materials and Methods: A descriptive, cross-sectional study was conducted on all children (≤16 years) who received blood transfusion in the Pediatric Department, Al-Sadaqa Teaching Hospital, Aden, Yemen over a time period of seven months. Data on age, gender, indications, type of blood product transfused, and adverse reactions were collected. Results: There were 360 transfusion episodes given to 202 patients, at a ratio of 2.3 transfusions per patient. The average age of transfused children was 5.63±4.63 years and 63.4% were male. Children ≤5 years comprised 50% of recipients. Single transfusion was most common (56.7%). Major indications were hemoglobinopathies (43.6%), and oncologic diseases (25.3%). The overall mean of pretransfusion hemoglobin (Hb) was 6.7±2.3 g/dL, varying by primary diagnosis, and the average Hb increment was 1.4 g/dL. The main types of transfused blood were red blood cell concentrates (58.9%) and whole blood (26.4%). Blood group O Rhesus D positive was the most requested (57.5%), followed by A positive (21.9%). Adverse transfusion reactions occurred in 4.4%, including febrile nonhemolytic (56.2%), allergic (37.5%) and transfusionassociated dyspnea (6.3%). Conclusion: Blood transfusion is a frequent supportive therapy in pediatric patients with various medical illnesses in this population. Most common indications were hemoglobinopathies and oncologic diseases. Regular review of blood transfusion is fundamental to ensure better and more rational use of this precious resource.