Objective: To explore the importance of pre-transfusion detection and blood selection for therapeutic efficacy in autoimmune hemolytic anemia. Methods: Blood group identification,irregular antibody screening and cross-ma-tching were performed with DG Gel confirmcards, Neutral cards, Coombs cards and WADiana/8XT Compact Analyzer (Diagnostic Gri-fols, S.A). Thetransfusion efficacy was assessed. Results: Both samples from the 2 patients showed agglutination of O cell and positive antibody screening test. The mimicking anti-C was identified in one sample based on the response pattern of panel cells, and autoantibody of another sample was not clearly identified. The health condition of both patients was improved after transfusing with red blood cells and the transfusion therapy was effective. Conclusions: In patients with autoimmune hemolytic anemia, the irregular antibodies were rather complex, therefore the blood cells without associa-ted antigen should be selected for transfusion according to the character of antibody. If the autoantibody showed mimicking Rh blood group characteristics, blood cells without the associated antigen were selected for transfusion. If the autoantibody was not clearly identified, blood cells with the same ABO blood group should be selected for the compatible test and that with the weakest reaction was chosen from multiple donors. If direct antiglobulin test was positive, especially the anti-C3d positive, donor's blood should be washed before transfusion to avoid hemolysis caused by the residual complement.