With a decline in incidence of hemolytic disease of the fetus and newborn as well as treatment with intravenous immune globulin and phototherapy, manual exchange in neonates and intrauterine transfusion have become uncommon. This session describes practices for not only ordering and preparing blood products for these rare procedures, but also how they are performed. The results of Vox Sanguinis International Forum on the Selection and Preparation of Blood Components for Intrauterine Transfusion published in 2020 will be reviewed. Participants will be updated on current indications, blood sample testing, blood product selection/preparation, calculations for dosing, and transfusion monitoring/documentation for intrauterine transfusion. For manual exchange transfusion, discussion will include procedure technique using push/pull versus continuous infusion methods, dosing/ordering, and blood component preparation.