Objective To evaluate the safety and effectively of transfusion plan guided by POTTS in gynecological patients with Hb level ranged from 60 to 100 g/L. Methods 114 gynecological patients with perioperative Hb level ranged from 60 to 100 g/L were randomly divided into POTTS group ( n=57 ) and control group ( n=57 ) . Patients in POTTS group received transfusion under the guidance of POTTS. Patients in control group received transfusion according to doctor's experience. The proportion of injecting RBCs,the amount of RBCs, the incidence of serious complications and mortality,ICU occupancy rate, postoperative Hb recovery, incision healing, hospitalization time, blood transfusion related costs and costs of hospitalization were observed and compared. Results The transfusion rate and volume in POTTS group were significantly lower than the control group ( P<0. 01 ) . Neither severe com-plications nor any mortality were found in each group. The transfusion costs in POTTS group were significantly less than the control group (P<0. 01). Two groups had no postoperative ICU admission;the postoperative Hb recovery, incision healing, hospitalization time and costs of hospitalization in two groups were not statistically significant. Conclusion POTTS could be safety and effectively used in gynecological patients with Hb level ranged from 60 to 100 g/L, also effectively save the blood, reduce the costs of blood transfusion, not increase perioperative mortality and the incidence of various complications.