Platelet transfusions are widely used in hospital practice, but, until recently, evidence from randomized trials to support this practice has largely been confined to studies in patients with hematological malignancies. Recent trials in preterm neonates and adults with intracerebral hemorrhage have raised questions about the relative safety and benefits of platelet transfusions. In preterm neonates less than 34 weeks’ gestational age without major bleeding, PlaNeT2/MATISSE investigators compared restrictive and liberal platelet transfusion strategies, implemented as platelet count thresholds of less than 25 × 103/μL and less than 50 × 103/μL, respectively. Perhaps paradoxically, results showed higher rates of major bleeding and death using the liberal strategy. In adult patients taking antiplatelet medications and experiencing intracerebral bleeding, the PATCH trial found signals of harm and worse outcomes in those receiving platelet transfusion compared with a no platelet control.