Hemopure® is a cell-free haemoglobin solution that is made from bovine haemoglobin that is designed to carry oxygen in the plasma. It is approved for use in South Africa for the treatment of acute surgical anaemia. We describe the use of Hemopure® at a large tertiary hospital in Cape Town where there is a blood bank on the premises. Four patients received Hemopure® during situations of acute, life-threatening anaemia. Two patients were Jehovah’s Witnesses and in two cases the blood bank was not able to find compatible blood due to the presence of antibodies in the patient’s blood. Patients were carefully monitored by the anaesthetists or intensive care staff, who were managing the patient. No adverse reactions were experienced. Hemopure® was indispensable in managing these critically ill patients.