The objectives of this study were (1) to evaluate the indications, complications and outcomes of multiple red cell transfusions (MrcTs) in cats; of these cats (2) to describe those that received massive transfusion and (3) compare them with those who received MrcTs over a longer time course. Twenty-seven cats were identified which received a total of 110 transfusions, with a median of three transfusions (range 3-15) per cat. The transfusions consisted of 47 units of whole blood and 63 units of packed red blood cells. The median age of cats was 6 years (range 6 months to 15 years). Cats were hospitalized for a median of 6 days, with a range of 1-38 days. No acute transfusion reactions were documented, although due to the critical nature of the cats, they may not have been appreciated. Sixteen cats survived to discharge and 11 died or were euthanased. Indications (and % survival) for transfusions included bone marrow failure (n=8; 50%); surgical loss (n=4; 100%), sepsis (n=3; 0%), neoplasia (n=3; 33%), acute renal failure (n=3; 66%), trauma (n=2; 100%), gastrointestinal bleeding (n=1; 100%), and cats with multiple disease processes (n=3; 33%). MrcTs are well-tolerated in cats and may be associated with a favorable outcome.