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Background: The need for autologous blood transfusion in our tertiary hospitals to restore patients’ hemodynamics with little or no complications cannot be overemphasized. Aims: This study is aimed at assessing surgeons’ challenges and patients’ readiness to accept autologous blood transfusion. Materials and Methods: It was a cross‑sectional study conducted at Enugu State University Teaching Hospital, University of Nigeria Teaching Hospital, Enugu, and National Orthopaedic Hospital, Enugu, from September to December 2020. A convenient sampling method was adopted in the distribution of questionnaires, and a total of 67 surgeons were enrolled in the study. Collated data were analyzed using SPSS software 21. Results: The study revealed that 60% of the respondents claimed that commercial donors were observed to be the major source of allogenic blood donation. Consequently, 34.3% and 80.6% of the respondents admitted that blood‑borne transmissible infections and blood transfusion reactions, respectively, were still a challenge in their practice. The outcome from this study also showed that 59% of the respondents claimed that their patients are not knowledgeable enough to make informed decision on the use of autologous blood transfusion while 52.4% of the respondents admitted that they do not have the facility for processing autologous blood transfusion. For the surgical specialties, all were willing to prescribe autologous blood transfusion for their patients, though no statistical difference (P < 0.05) exists among the specialties. Conclusion: Autologous blood transfusion has remained the mainstay as effective and safest means of blood transfusion in overall patient care; hence, surgeons should incorporate this concept into their practice to enable patients make an informed decision.