BACKGROUND: Umbilical cord blood (UCB) transplantation is becoming more widely used, yet ethical and policy issues regarding consent and health history persist. Whereas most UCB banks do not require paternal consent or paternal health history (PHH), both are obtained at this institution whenever possible. This study assessed the value of PHH in making UCB safer. STUDY DESIGN AND METHODS: A retrospective review was performed of all cord blood units (CBUs) collected by this bank between November 1999 and October 2000. All discarded CBUs were studied to identify those deferred based exclusively on PHH provided by the father in the PHH questionnaire. RESULTS: PHH was obtained for 301 of 655 (46%) CBUs collected. Of the 339 CBUs banked, 269 (79%) had PHH available. Three of the 301 CBUs in which PHH was available were discarded based solely on PHH, since maternal medical history and infectious disease testing were negative. Paternal high-risk factors in those three cases were: gave money or drugs for sex; traveled to an HIV high-risk area; and did not answer high-risk questions. CONCLUSION: Considerable time and effort is expended in the process and follow-up of obtaining PHH with an overall indistinct and unconvincing role in minimizing infectious disease transmission risk in UCB banking.