Objective: Thrombocytopenia is a very common problem in neonatal intensive care unit whose only specific treatment is platelet (PLT) transfusion which has well-known risks. Our aim is to test whether using PLT mass-based transfusion guideline would result in fewer transfusions or not.Methods: One hundred neonates with PLT count <100000/l were randomized into two groups: Group 1 (n=50) was transfused according to PLT count-based guideline, whereas Group 2 (n=50) was transfused according to PLT mass-based guideline. Subjects receiving one or more PLT transfusions and total number of PLT transfusions, hemorrhages, morbidity and mortality in both groups were recorded.Results: Demographic characteristics, PLT counts of the infants and clinical conditions associated with thrombocytopenia in both groups were not different. There was no reduction in the number of subjects receiving PLT transfusions (54% in Group 1, 50% in Group 2; p=0.69) and in the number of PLT transfusions per infant (0.821.13 versus 0.8 +/- 1.23; p=0.95). There was also no difference with respect to bleeding, morbidity and mortality between the groups.Conclusion: Transfusion according to PLT mass or PLT count-based guideline does not seem to influence number of transfusions or the number of infants who were transfused.