This chapter provides a comprehensive overview of blood conservation strategies, which are essential to patient blood management, aiming to minimize blood transfusions during and after surgery. Starting preoperatively, these strategies involve patient-centric decision-making, identifying high-risk patients, managing anemia, and optimizing coagulation. Anemia, prevalent in cardiac surgical patients, significantly increases the risk of adverse outcomes, highlighting the need for preoperative management. In addition to treating anemia and managing anticoagulation medications, preoperative management can include preoperative autologous donation (PAD). Concentrated intraoperatively, blood conservation efforts employ both pharmacologic (such as antifibrinolytics and topical hemostatic agents like gelatin sponges or topical thrombin) and non-pharmacologic measures. Goal-directed transfusion algorithms, incorporating point-of-care testing, help minimize unnecessary transfusions, alongside the use of cell saver systems and, less commonly, acute normovolemic hemodilution. Perfusion interventions play a vital role in blood conservation strategies, minimizing cardiopulmonary bypass (CPB)-induced hemodilution through techniques such as minimally invasive extracorporeal circulation (MiECC) and microplegia. Vacuum-assisted and kinetic-assisted venous drainage techniques enable CPB circuit volume reduction without compromising venous drainage. Ultrafiltration and modified ultrafiltration are utilized for excess fluid volume removal and hemoconcentration of both the circuit’s and the patient’s blood. Retrograde autologous priming, which involves replacing the circuit’s clear prime with the patient’s blood, is also employed to mitigate hemodilution. Blood management should persist through the postoperative period, where transfusion protocols play a vital role in minimizing unnecessary blood transfusions.