Blood Manipulation allows the user to control all aspects of their own blood composition. Using Flowing Red Scale, the user can increase their body temperature, pulse rate, and the number of red blood cells to give themselves greatly increased energy and physical abilities. Enhanced strength and speed granted by Flowing Red Scale can be used to boost the user's capabilities in hand to hand combat.
When this ability is activated, a blood marking appears over the user's eyes which visually differs from user to user.
When Noritoshi activates this technique, an "X" pattern over his right eye appears. After using his last arrow to obscure his opponent's view, Noritoshi chose to employ a direct attack against Megumi, a Shikigami user, thus activating this ability to improve his physical capabilities. His speed was great enough to catch Megumi off guard even though his view was only obstructed for a second. Noritoshi's strength broke through Megumi's tonfa using his bare hands and threatened to do more damage if not for his Jujutsu Protection. He is able to keep this ability activated during a whole fight against Hanami and able to utilize other Blood Manipulation techniques at the same time.
When Choso activates this technique, two vertical lines that cross over each of his eyes appear. He utilized this technique first time against Yuji Itadori to engage in physical combat by pumping blood faster throughout his body, allowing them to take in more oxygen. Choso is also able to use this to a higher degree by increasing output to match Yuji`s superhuman strength. When using Stack, the vertical lines over Choso's eyes become longer while the line over his nose becomes thinner as well. He is also able to channel it into specific bodily functions such as focusing it on his ocular muscles in order to read Naoya's movements.