Blood transfusion therapy is widerly used in pediatric surgery as it's validity in many acute and chronic pediatric diseases.Compared to adults,pediatric perioperative transfusion therapy,particularly the approach to massive blood transfusion can be quite complex because of the unique physiologic characteristics.Perioperative transfusion therapy in children can cause significant metabolic disturbance,and further,cause severe complications.This paper presents an overview of the physiologic characteristics which related to pediatric perioperative transfusion therapy.And also the metabolisms related to massive perioperative blood transfusion in children.These may accordingly primarily useful to treat the pediatric patients.