OBJECTIVES: Due to an ongoing increase in demand for blood transfusions alongside a decline in blood donation and concern about the safety of donated blood, there is a crisis in blood donation. This study therefore aims to evaluate different motivators for blood donation focusing on the potential of incentives to increase donation, whilst maintaining blood safety. METHODS: A literature review was carried out. Medline, Embase and Psychinfo databases were searched and studies about autologous and non-whole blood donation and those in developing countries were excluded. RESULTS: The included studies were varied in focus, study design and conclusions. They researched the impact of different types of incentives examining their ability to attract donors and maintain blood safety by preventing disease transmission. Commonly mentioned incentives were free medical tests, blood credits, paid time off and tickets to events, such as concerts. The success of incentives to attract donors is dependent upon age with younger donors being more receptive to most incentives than older donors. However, offering free cholesterol and PSA screening also motivates older donors. Using these types of medical tests as incentives is unlikely to detrimentally affect blood safety. However, there is considerable debate concerning the use of incentives with monetary value. There are data showing that the safety of donated blood is not adversely affected by such incentives, but there are also data showing a high response to such incentives by high-risk donors who donate in order to receive HIV testing. CONCLUSIONS: The positive impact of incentives with monetary value is limited by their appeal to donors from high-risk groups. However, if blood incentive programmes are organised at regional or communal levels as opposed to national levels it may be possible to take advantage of their appeal to younger donors in areas with low levels of HIV-risk behaviours.