Background: Blood transfusion is considered one of the most effective therapeutic alternatives in the treatment of certain conditions, although it is lifesaving, there is a risk for the patient to develop transfusion-related adverse reactions. Nursing professionals have a central role in the transfusion process. The aim of the study: is to assess correlation between nursing practices regarding blood transfusion among patients at medical department and its adverse reactions. Research design descriptive correlation research design was utilized in the current study. Subjects A convenience sampling of (39) adult patients who were going to receive blood transfusion were included in the current study. Setting: This study was carried out in medical department at Minia university hospital. Tools of data collection: Two tools were used in this study: 1-Patient's assessment sheet 2- immediate reactions of blood transfusion assessment sheet. Results: illustrated that there were a markedly decline in the total nursing practices regarding three phases of blood transfusion (pre, administration  and end) for studied sample as the Mean ± SD was 11.7 ± 0.9 Conclusion: there was a negative correlation (-0.080) between the studied sample' immediate blood transfusion adverse reactions and level of blood transfusion practices score. Recommendations: Based on the research findings the researcher recommended that in-service training programs based on evidence practice and regular inter- professional meeting that illustrate purposes and guideline procedure of safe blood transfusion administration to nursing staff that have positive effects on patient's safety outcomes should be provided.