A 22-year-old male Jehovah’s Witness was referred to a MedStar hospital with a bloodless medicine and surgery program from a hospital where transfusion was the only treatment option offered to him. His hemoglobin upon admission was 3.7. He was evaluated by the bloodless medicine and surgery team and was found to be profoundly iron deficient (ferritin level 1mg/ml, transferrin saturation 3%). Iron repletion and other supportive therapy corrected his anemia and he was discharged from the hospital with a hemoglobin level of 7.6; one week after discharge his hemoglobin was 10.3.