The concept of patient blood management is such that if a patient with anemia can be identified in the pre-operative period, therapeutic modalities can be targeted to that patient who might benefit from such treatment. Management strategies include the optimization of preoperative hemoglobin by maximizing hemopoiesis and RBC mass. This can best be achieved with the use of iron supplementation, either oral or intravenous, with or without the use of erythrocyte stimulating agents (ESAs) such as erythropoietin. The use of i.v. iron and ESAs is reviewed. Different i.v. iron formulations available are discussed along with current indications and contraindications for the use of ESAs.