Transfusion Medicine is one of the youngest medical branches. The specialty started around 1900 with the discovery of red cell characteristics (blood groups) by Landsteiner and his research group. Although it opened the door to more safe clinical transfusion, the field explored largely the more technical laboratory aspects related to the manufacturing and preservation of blood and blood products and the provider of the human source material, the blood donor. As a consequence, education largely covered these technical elements focusing on laboratory skills, test tube oriented. That raises the question: is it knowledge or the regular skills which are regarded to be the most important? There is a great variety of educational or learning curricula designed around the technical laboratory aspects of Transfusion Medicine, with little attention to the important aspects of knowledge, the deeper background of theoretical aspects. Much education or learning is not systematically and nationally organized and often locally provided by non-professional teachers. The data assembled by the World Health Organization and UNDP, but also through surveys conducted by professional associations provide a sad picture that needs focused action of governments particularly in the Low-and Middle-Income Countries (LMICs). The review illustrates the importance and economy or sharing of knowledge as the driving force in education: awareness and understanding, an education environment and a learning climate under the guidance of the Ministry of Education – policy and strategies, legal system and regulation of the education system to respect recognition of education outcomes and implementation of the required knowledge.