143 fresh blood transfusions were given to 32 low birthweight babies, 28 of whom had hyaline membrane disease. The arterial or central venous pressure was raised by a blood transfusion if before transfusion the mean arterial pressure was less than 35 mmHg or if the diastolic central venous pressure was less than -- 0-5 mmHg. There was no effect of blood transfusion on pH. It therefore appears either that metabolic acidosis in hyaline membrane disease is not caused by poor peripheral perfusion or that blood transfusion does not increase peripheral blood flow in this condition. The safety of the procedure is assessed.