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When performing a routine phlebotomy, the most common gauge needle used is the 20 or 22, not 18 or 20, 22 or 24, or 16 or 18. This is because the 20 or 22 gauge needles are versatile and can be used for most blood collection purposes. 18 or 20 gauge needles are larger and may be more commonly used for procedures that require higher blood flow rates, such as blood transfusions. 22 or 24 gauge needles are smaller and may be used for more delicate procedures, such as pediatric blood collection or for patients with fragile veins. 16 or 18 gauge needles are larger and are typically used for procedures that require larger amounts of blood, such as bone marrow aspiration or donations. Therefore, the most common gauge needle used for routine phlebotomy would be the 20 or 22 gauge needle