Background: The German population will decrease by 16% until 2050, and the ratio of young to old people is shifting towards the elderly. Because risk of disease rises with age, an aging society will be confronted with a higher burden of diseases. Methods: A projection of status quo case numbers and crude rates of selected diseases was done for the years 2030 and 2050. Actual sex-and age-specific rates were transferred to the predicted population figures (11th coordinated population prediction). Results: Cancer incidence will rise from 461,000 (2007) to 588,000 cases (2050) (+27%). Crude incidence rate will increase by 52%. Number of femoral neck fractures will rise by 88% (rate +122%). For other diseases incidence and prevalence will increase up to 144%. Conclusion: Blood (products) will be necessary for the therapy of many of the presented diseases. Therefore, it can be assumed that future demand of blood will rise in a similar manner as the rising number of diseases. The projected developments describe an extraordinary challenge for the German health care system and in particular for transfusion medicine. It is necessary to develop new concepts to meet this future demands and to ensure a high-performance health care system.