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Before your procedure

Preparing for a — Bone Marrow Biopsy

A bone marrow biopsy is the procedure most people arrive dreading. The fear is almost always bigger than the reality. Knowing exactly what to prepare makes the day significantly easier.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • Fasting may be needed — Whether you fast depends on whether sedation is planned. Your team will tell you — call if they have not.
  • Blood thinners need a decision — Do not stop them without asking your haematologist. They decide based on your full medicine list.
  • Bring someone with you — You will not be able to drive or travel alone after the procedure. Arrange this before the day.
  • Tell your team everything you take — Herbal medicines, supplements, and over-the-counter tablets all matter, not only prescriptions.
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Fasting is usually required if sedation is planned — your team will confirm the specific window. Do not stop blood thinners without your haematologist's guidance. Wear loose, comfortable clothing. Bring a companion to take you home, and a written list of every medicine, supplement, and herbal preparation you take.

What do the medical words on your form mean?

Bone marrow
The soft tissue inside your larger bones where blood cells are made. A biopsy takes a small sample of this tissue to examine under a microscope.
Aspiration
Drawing out the liquid part of the marrow with a syringe. This is the step that can cause a brief, sharp pressure — it is short.
Trephine biopsy
A small solid core of marrow tissue taken with a hollow needle. It gives more information than aspiration alone. Most biopsies include both steps.
Posterior iliac crest
The back of your hip bone, just above the tailbone. This is almost always where the needle is inserted.
Local anaesthetic
A medicine injected into the skin and the surface of the bone to numb the area. You stay awake, and the site should feel numb before anything else begins.

Do you need to fast before a bone marrow biopsy?

Whether you need to fast depends on whether sedation is part of your procedure. If sedation is planned, you will usually be asked to avoid food and drink from a set time beforehand. Your appointment letter or the nurse who booked you will give you the exact window.

If no one has mentioned fasting, call and ask. Do not assume it is fine to eat as usual. Arriving having eaten when you were asked not to can mean your appointment has to be rescheduled.

If you have diabetes and are asked to fast, do not adjust your medicine on your own. Call your team and ask specifically what to do — this needs guidance, not guesswork.

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Should you stop blood thinners before a bone marrow biopsy?

Do not stop blood thinners on your own. This is a decision your haematologist makes, based on why you are taking them and what they are.

Tell your team about every medicine you take — blood thinners, anti-platelet tablets, herbal preparations, and anything bought over the counter. Do this when you book, not on the morning of the procedure.

If you have already booked and have not told them, call now. Your medicine list is one of the most important things you can give your team before the procedure begins.

What else do you need to arrange before the day?

What to wear

Wear loose, comfortable clothing. The needle goes into the back of the hip, so anything that moves aside easily — loose trousers, a comfortable sari — works better than something tight or tailored. Some centres provide a gown, but your own comfortable clothing is fine. Leave jewellery at home.

What to bring

Bring a written list of every medicine you take — including herbal, ayurvedic, and over-the-counter preparations. Your team needs the full picture, not just the prescriptions. Bring your insurance documents if they apply. Bring a family member or friend who can stay with you and take you home.

Arranging your journey home

You will not be able to drive or ride a two-wheeler home after this procedure. You will have had local anaesthetic, and possibly sedation, and you may feel tired or sore. Most centres will not discharge you without a companion present to take you. Arrange this before the day — not on the morning of it.

If you take medicine for a heart condition

Cardiac medicines — particularly those that thin the blood or affect clotting — need a specific decision before any biopsy. This is not something to guess. It may require a conversation between your haematologist and your cardiologist. Raise this when you book so there is enough time to make the decision before the procedure.

The evening before

Eat and drink normally the evening before unless your team has told you otherwise. Get as good a night's sleep as you can. It helps to know that the procedure is short, that you will be told what is happening at each step, and that local anaesthetic is given before anything else begins.

Did you know?

Most people describe anticipating a bone marrow biopsy as harder than the procedure itself.

Studies in haematology practice consistently find that anxiety before the biopsy is greater than the discomfort people report during it.

Source: British Society for Haematology: Guidelines on the Performance of Bone Marrow Aspirates and Trephine Biopsies

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Common questions

Frequently asked questions

Will a bone marrow biopsy hurt?

You will feel the local anaesthetic injection, and then a brief, sharp pressure during the aspiration step. Most people describe that moment as intense but short. The trephine biopsy that follows is usually felt as pressure rather than sharp pain. Most people say the experience is considerably less than they imagined. If you feel more than pressure during the procedure, tell the person doing it — they can pause and add more numbing medicine before continuing.

Can I eat breakfast before a bone marrow biopsy?

This depends on whether sedation is planned and what your team has told you. If they have not asked you to fast, you can eat and drink normally. If they have asked you to fast, follow that instruction carefully. If you are not sure what you were told, call before the appointment — turning up having eaten when you were asked not to can mean the procedure has to be rescheduled. When in doubt, call.

Can I drive home after a bone marrow biopsy?

No. You will have had local anaesthetic, and possibly sedation, and you are likely to feel tired or sore afterwards. You must arrange for someone to take you home. Do not drive, ride a two-wheeler, or travel alone on public transport. Most centres will not discharge you unless a companion is present. Plan this before the day — not on the morning of it.

When will I get the bone marrow biopsy results?

Results are not available the same day. The sample has to be processed and examined by a pathologist, which takes time. Your treating haematologist will contact you once the report is ready and will explain what it means in the context of your overall situation. Results are routed to your haematologist — do not contact the laboratory directly, as they are not the right person to interpret the findings with you.

What if I forgot to tell my team about a medicine I take?

Call before your appointment, even on the morning of the procedure. Blood thinners, anti-platelet medicines, and herbal supplements all affect bleeding risk, and your team needs to know before the needle goes in. If you are already at the centre, tell the nurse before you go in — it is not too late, and your team would rather know. Saying nothing is the one thing you should not do.

Do I need to be admitted to hospital for a bone marrow biopsy?

Usually not. A bone marrow biopsy is most often done as a day procedure, and most people go home the same day after a period of observation. If your overall health situation means you need closer monitoring overnight, your haematologist will tell you this in advance and arrange an admission — you will not find out on the day without warning.

Full index

Browse all 701 biopsy topics

Every page in this section, grouped by the part of the journey it belongs to. Pick a group to see what is in it.

What Is a Biopsy?

What Is a Biopsy? Everything You Need to Know →

Types of Biopsy Compared

Which Biopsy Will You Have? Techniques Compared →

Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

After a Biopsy: Recovery, Aftercare and Warning Signs →

Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

How to Read a Biopsy Report: Terms Explained →

IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

Cytology & Prostate Scoring Systems Explained →

How Accurate Is a Biopsy?

How Accurate Is a Biopsy? Errors and Second Opinions →

If Your Result Is Benign

Your Biopsy Is Benign: What It Means and What Comes Next →

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