Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 9 2 2025 06 16 e18 e18 Audrey Marcotte Department of Emergency Medicine, McGill University, Montreal, Quebec, Canada Maryam Bahreini Department of Emergency Medicine, Tehran University of Medical Sciences, Tehran, Iran 2025 06 13 2025 06 14 Massive hemorrhage protocol (MHP) is an updated term for the formerly used massive transfusion protocol, highlighting crucial aspects of hemorrhage management other than the transfusion itself. This complex intervention includes acute hemorrhage control; administering tranexamic acid (TXA), preventing hypocalcemia, hypothermia, and acidosis; reversing anticoagulation or correcting coagulopathies; and planning for the next steps in definitive hemorrhage control. Here, we discuss exciting frontiers and challenges of MHP. https://fem.tums.ac.ir/index.php/fem/article/view/1614 https://fem.tums.ac.ir/index.php/fem/article/download/1614/521