Abstract: Objective To study the effect of combined serum ferritin (SF) and erythropoietin on heterogeneous blood transfusion in perioperative gynecological anemia patients. Methods Sixty anemia patients with hysteromyoma who underwent operation in our hospital from August 2012 to November 2012 were divided into experimental group with their Hb ≤ 70 g/L (n=30) and control group with their Hb ≤ 100 g/L (n=30). Patients in experimental group were subcutaneneously injected with 5 000 IU human erythropoietin and intraveinous injected with SF before operation and on the day of operation. White and red blood cell suspension was transfused depending on their perioperative Hb level. Hb, Hct, RET%, RBC, SF and complications were recorded 4 days before operation, on operation day, and on day 1, 3, 5 after operation. The patients were followed up for 1 month after operation during which their hemoglobin was recorded. Results The Hb and Hct levels and RET% were significantly higher in experimental group than in control group on day 0, 1, 3, 5 after operation(P< 0.01). The SF level was significantly higher in experimental group than in control group(P< 0.01). The perioperative heterogeneous blood transfusion was significantly less in experimental group than in control group (1 U vs 20 U, 0.07 U/case vs 0.67 U/case, P< 0.01). Conclusion Combined erythropoietin and SF can effectively improve anemia and reduce heterogeneous blood transfusion in perioperative gynecological anemia patients.