Background: Dengue Hemorrhagic Fever (DHF) is a severe, life-threatening complication of dengue virus infection, characterized by plasma leakage, thrombocytopenia, and potential hemorrhage. As there is no specific antiviral treatment, supportive management is paramount. Blood component therapy, including platelets and plasma, is a critical intervention to correct coagulopathy and stabilize patients. Objective: To analyze the utilization patterns, determinants, and clinical outcomes of blood component therapy in patients with DHF. Methods: A prospective observational study was conducted at Bangabandhu Sheikh Mujib Medical University from July 2021 to August 2022. Data from 290 laboratory-confirmed dengue patients, including 73 with DHF, were analyzed. Parameters included demographics, DHF grade, transfusion details, laboratory trends, and clinical outcomes. Statistical analysis used SPSS 23.0, with Chi-square and ANOVA tests for comparisons; a p-value <0.05 was considered significant. Results: Transfusion was administered to 71.3% of DHF patients, predominantly platelets alone. Requirement was strongly linked to severity, with 84.0% of severe cases receiving therapy. Key risk factors included warning signs and high hematocrit. Post-therapy platelet counts and hematocrit levels normalized significantly. Combination therapy was associated with longer hospital stays (7.4 days) and higher complication rates (e.g., 30% fluid overload), yet discharge rates remained high across all groups. Conclusion: Blood component therapy is crucial for severe DHF, effectively stabilizing hematological parameters. A targeted, severity-based approach is recommended to optimize outcomes and minimize complications associated with combination transfusions.