Dendrimers provide many exciting opportunities for potential biomedical applications. However, owing to their positively charged surfaces, poly(propyleneimine) (PPI) dendrimers show toxic and haemolytic activities. One of the methods for masking the peripheral cationic groups is to modify them using carbohydrate residues. In this study, three types of the fourth generation PPI dendrimers-uncoated (PPI-g4), approximately 35% maltotriose (Mal-III)-coated (PPI-g4-OS), and approximately 90% Mal-III-coated (PPI-g4-DS) were investigated by assessing their effects on red blood cell (RBC) haemolysis in samples of pure RBCs, RBCs in the presence of human serum albumin (HSA) or human plasma, and RBCs in whole blood. Lymphocyte proliferation and platelet (PLT) aggregation were also studied in the presence of various concentrations of dendrimers. Although all dendrimers examined affected all the blood cells studied, the unmodified PPI-g4 had the most damaging effect. It caused high RBC haemolysis rates and PLT aggregation and greatly inhibited lymphocyte proliferation. These effects were caused by the cationic surface of this polymer. The modification of PPI-g4 with Mal-III reduced the effect of the dendrimer on all blood cells. The presence of HSA or plasma in the buffer containing the RBCs or RBC in whole blood significantly decreased the extent of dendrimer-driven haemolysis. (C) 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 100A:28702880, 2012.