Abstract. The aim of this study was to examine the manner in which varying proportions of serum and red blood cells (RBC) in massive blood transfusion affect the survival rates of patients with severe blood loss. Massive transfusion (MT) was determined as receiving ≥10 units of red blood cells in 24 h. The electronic medical records and blood transfusion information for the period January, 2002 to December, 2011 of patients with MT were examined. Moreover, we calculated the ratio of blood components and examined their correlation with survival. In total, 1,658 patients underwent MT during the period 2002-2011, with an overall of 28,030 units RBC, accounting for 2.8% of the total blood transfusion. In conclusion, fixing blood-component ratios has the potential to help improve survival rate in MT.