Objective  To investigate the patient blood management for sacral neurilemmoma resection. Methods  Retrospectively analyzed the blood administration and surgical procedures during 12 sacral neurilemmoma resection from Beijing Shijitan Hospital Affiliated to Capital Medical University from September 2012 to December 2016, to discuss the preoperative preparation, anesthetic induction and maintainance, intraoperative monitoring and use of vasoactive drugs related experience. Results  12 patients with sacral neurilemmoma were resected with marginal margin. Sacral 1 nerve was not preserved only in 1 patient, foot droop nerve dysfunction occurs. The remaining 11 patients successfully dissociated the nerve from the tumor and preserved the nerve. One patient suffered from cerebrospinal fluid leakage after surgery, and was cured after drug exchange and symptomatic treatment. The average follow-up time was 13 months, and there was no recurrence of schwannoma. Intraoperative blood loss was (15,004±670) ml, mean allogeneic blood transfusion use (1,567±247) ml. Through the implementation of the medical strategy of blood management, the intraoperative circulation remained stable, and all patients stopped taking blood tube active drugs within 1 hour after surgery, and the tracheal tube was removed and sent back to the ward. Conclutions  Blood management programs including erythrocyte enhancement drugs and stored autologous transfusion are effective ways to reduce the bleeding of sacral schwannoma.