The decision to treat a patient with therapeutic apheresis depends on multiple factors, such as what does the patient most likely have, is the diagnosis amenable to apheresis treatment, what is the harm-versus-benefit ratio of apheresis treatment in this patient, and what are the internal and external issues associated with receiving apheresis treatment? The "Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-based Approach from the Writing Committee of the American Society for Apheresis" addresses these issues and helps aid in clinical decision making. The development and application of these Guidelines as well as potential new applications will be discussed in this article.