This guidance update from the BSH is focussed primarily on non-surgical invasive procedures, simply termed ‘procedures’ in this document, with the primary objective of giving pragmatic advice where evidence is limited. This guidance also aims to reduce unnecessary laboratory testing, inappropriate use of blood products and unnecessary delays in therapeutic procedures.1 It should be read in conjunction with the Interventional Radiology (IR) procedure bleeding risk guidance produced by the British Society of Interventional Radiology (BSIR) and the BSH.2 Recommendations are predominantly based on evidence from adult patients and therefore may not be applicable to neonates or very young children.