Background The aim of our study was to estimate the efficacy of treatment the fetal hemolytic disease by intravascular transfusions (IVT). Method In the group of 71 immunized patients, after 21 weeks' gestation we performed amniocentesis. Results of the optical density at 450 nm in 2nd or 3rd zone in Liley's scale were an indication for cordocentesis, fetal blood sampling and in cases with low values of blood parameters – intravascular transfusion with drugs administration. In some cases we chose elective preterm cesarean delivery. The management depended on the gestational age, fetal maturity, blood parameters, ultrasound examination and FHR patterns. Results The number of 24/71 patients required IVT. We transfused 20–90 ml of blood in 3–10 days intervals. The total amount of IVT was 78: 65/78 into a free loop of umbilical cord and 13/78 into its placental insertion. In 22/24 cases there were born healthy neonates, five of them required exchange transfusion because of hyperbilirubinemia. We observed one intrauterine death 10 h after IVT, probably due to cord hematoma and one death of hydropic neonate 48 h after delivery. Conclusion The treatment of fetal hemolytic disease by IVT is associated with high perinatal survival rate and low perinatal mortality rate.