Over a three month period an audit of the use of emergency blood tests was carried out in the accident and emergency (A&E) department at Southampton General Hospital. Few blood tests were found to be useful in the primary assessment and treatment of patients by the attending doctors. Only cross-matching of blood, an amylase level and an arterial blood gases were felt to be consistently of clinical benefit in the acute management of the patient. The reasons for inappropriate investigations and possible solutions are discussed. Significant cost savings can be made, allowing for better targeting of resources.