OBJECTIVES: Through a literature review, evaluate the incidence rates of different adverse events associated with blood transfusions among the general population. METHODS: A structured, 2-phase literature review was conducted using the PubMed (National Library of Medicine) database to search for articles quoting incidence rates of adverse reactions associated with blood transfusions. The first phase of the literature review looked for general blood transfusion risk studies reported during the time period of 1985 to 2007 to identify adverse events associated with blood transfusions. The second phase of the literature review, looking at studies reported 2000 to 2007, assessed incidence rates for each adverse event identified during the first phase. The search generated 41 articles from which data were extracted and summarized. RESULTS: The study identified 16 adverse events associated with blood transfusions in which incidence rates were reported in the literature for the time period of 2000 to 2007. Of those, the adverse events with the highest associated mortality rate were: 1) acute haemolytic transfusion reactions due to non-ABO compatibility (between 2.11%-7.06%); 2) transfusion-related acute lung injuries (TRALI) (10% approx); and 3) bacterial sepsis (between 17%-22%). Reported as incidence rates, the most frequently reported adverse event was febrile reaction (0.9/1000 by transfusion units) and mild allergic reaction (1/50-1/100 by transfusion units). CONCLUSION: In spite of today's safety and quality controls measures for blood transfusions, a considerable risk of adverse events is still associated with them. Therefore, alternatives to blood transfusions should be considered when possible.