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Background and Objectives Blood transfusion is a major challenge in treating trauma patients. This study investigated blood transfusion rates and related factors in trauma patients. Materials and Methods This retrospective cross-sectional study analyzed 849 trauma patients admitted to a trauma center in Shiraz, Iran during 2019-2021. Blood components usage and its relation to demographics, clinical status, lab values, and ABC score were assessed. The frequency of massive blood transfusion and the average number of blood units and blood components consumed in these patients were surveyed. Data were analyzed by T-test, Chi-squared test, and logistic regression with SPSS-23. Results The mean age was 38.6 ± 19.40 years and 80.9% were male. The mean blood units, platelets, and plasma used were 5.74 ± 4.57, 1.21 ± 4.87, 2.73 ± 4.32, respectively. 62.01% received massive transfusion with mean blood, platelets, and plasma units used being 8.17 ± 5.21, 3.92 ± 4.88 and 1.85 ± 6.01, respectively. Blood use correlated with systolic/diastolic pressures, blood sugar, lymphocyte count, pH, bicarbonate, base deficit, and hematocrit. 13.3% had positive ABC score and received more blood products (p < 0.001). Conclusions Blood transfusion in trauma patients depends on various clinical and lab factors. Identifying high-risk patients requiring urgent blood transfusion and rapid preparation of blood products is vital for optimizing trauma patient management and outcome. [ABSTRACT FROM AUTHOR]