Vacuum tubes were first marketed by U.S. company BD (Becton, Dickinson and Company) under the trade name Vacutainer tubes. Today, many companies sell vacuum tubes as the patent for this device is in the public domain. Some models are a type of test tube that contains a vacuum that automatically aspirates blood into itself. The tubes are made of glass or plastic. The tubes are attached to a needle and hub.

Multiple vacuum tubes can be attached to and removed in turn from a single needle, allowing multiple samples to be obtained from a single procedure. This is possible due to a Japanese invention called the multiple sample sleeve, which is basically a plastic cap fitting over the posterior end of the needle cannula, thus keeping blood from draining onto both health care worker and patient.

BD used this invention to create a system that included the vacuum pressurized sleeve, and a cannula with sleeve attached to a holder that holds the needle/sleeve combination, and guides the negatively pressured collection vial that is inserted once the needle is in the patient. Unfortunately, the sleeve that stops blood from moving until its seal is perforated by the collection tube's insertion, also prevents flashback, the tell-tale sign the vein has been entered properly. If the phlebotomist chooses to use a butterfly needle, the "flash" is still present, and easily visible to the phlebotomy tech as well as the patient.

They are commonly used in US, UK, and Australian hospitals, private doctors' offices and community labs, and are available in various sizes to suit the age of the patient and the type of sample needed.

There are several sized needles for a phlebotomist to choose from. The most commonly used are as follows: a 21g (green top) needle, a 22g (black top) needle, a 21g (green label) butterfly needle, a 23g (blue label) butterfly needle, and a 25g (orange label) butterfly needle (however this needle is only used in pediatrics or extreme cases as it is so small that it can often result in hemolizing the blood sample, thereby invalidating the test). Most lay people are under the impression that using a butterfly needle is easier on their veins and less painful. Using a finer needle is less painful. However, the hazard of using butterfly needles lies in the fact that as the blood flows through the rubber tubing, it cools significantly, thereby clotting faster. In clotting in the tube, it stops up and reduces or as in most cases, completely stops. When this happens, it is necessary to re-stick a patient in order to obtain the blood sample. This is not the case when using the more common needles. Since the tubing is not a part of the needle, the blood goes through the needle directly into the tube. This method results in a faster, cleaner sample with less chance of haemolysis. (When a blood sample is hemolyzed, it means the red cells have ruptured to the extent that they impart a pink/red color to the blood plasma, which is normally pale yellow.)^[