Objective to observe the safety, efficiency and factor that predispose to poor outcome or complications Study Design: Retrospective study Place and Duration The study was conducted from May 2007 to April 2010 at Isra university Hospital Hyderabad. Patients and Methods: We have reviewed the plasma aphaeresis records of all 200 therapeutic plasma exchange procedures performed on a total of 44 patients with a mean age of 50+-10 years, 30 (68.5%) were male and 14 (31.5) were females, continuous flow cells separator by Fresenius Kabi were used for TPE. TPE was generally given every other day for all of the patients and one plasma volume was exchanged for each cycle. Inclusion criteria: Patients were included were neurological disease & Hematological disease. Exclusion criteria: Patients which are suffered from cerebral stroke, were excluded from study. Results: Most commonly Guillain Barre syndrome 28(64%), myasthenia gravis 6 (13%), paraproteinemic neuropathy 3(6.5%), chronic inflammatory demyelinating polyneuropathy 5(12%) and Goodpasture syndrome 2 (4.5%) During TPE procedure, no patients had any morbidity or mortality, and the complications were mild and manageable such as hypotension, hypocalemia, rashes at the site of canola. Complications of plasma exchange were noted during 25% (n = 11). These include hypocalcaemiain 8% of the patients, urticarial reactions in 7.3%, pruritic reactions in 12%, and hypotension/headache in 6.8%. No major procedural complications were seen. Conclusion:Over all our data shows that the plasma exchanges is an effective and safe procedure especially for a variety of neuro immunological conditions.