While often used interchangeably, hijama and bloodletting are not similar techniques. Bloodletting opens veins and bleeds patients, whereas hijama draws blood to a specific location with suction and extracts it by perforating the skin. “A study by Bilal and colleagues was aimed by comparing and analyzing the difference between the compositions of blood samples, obtained through cupping (hijama) technique versus blood drawn intravenously. There was a significant change in almost all parameters tested as compared to the venous blood samples to scientifically evaluate the efficacy of the techniques used in cupping (hijama)

Cupping has few major side effects aside from the pain of skin cuts. One potentially serious risk is infection. Other possible minor side effects that may occur is feeling of slight light headedness post therapy, this is similar to the sensation one feels after having blood taken when donating blood. Cupping [hijama] encourages blood flow to the cupped region (hyperemia), one may therefore feel warmer and hotter as a result of vasodilatation taking place and slight sweating may occur. Pregnant women or menstruating women, cancer (metastatic) patients and patients with bone fractures or muscle spasms are also believed to be contra-indicated. Some practitioners suggest that a low risk of blood clotting is possible and therefore walking and staying awake after a procedure is advisable