In this review of common and uncommon donor reactions and injuries, donation-associated deaths were found to be extremely rare and generally thought to be coincidental; the rate of coincidental deaths was less than what would be expected based on life insurance tables. Vasovagal reactions, hematomas/bruises, and history of irritation or allergic reaction to adhesive tape or skin preparations are observed daily in a busy blood collection center. Syncopal vasovagal reactions sometimes resemble shock, but unlike shock, they reverse themselves and do not cause death. Through good management, a blood donor organization can minimize the incidence of syncope. Accidental arterial venipuncture is very uncommon (1 in 100,000), and donors with arterial punctures do well if pressure is applied for an extended period of time. Rarely, a pseudoaneurysm results, and this requires surgery. AV fistulas and compartment syndromes can also occur, but these are extremely rare; most experienced blood center physicians have never observed a case. Neurologic needle injuries occur approximately once in every 6,300 donations. Although neurologic needle injury complaints are usually received within 10 days of blood donation, 10% of the injured donors may complain weeks to months later. Most donors with needle injuries recover within a month and many within a day or two, but approximately 30% will have a recovery period of greater than 1 month and an occasional case may exceed 6 months. Donors with neurologic needle injuries generally have a full recovery, even when the recovery period may be extended. Thrombophlebitis has a low incidence (1 in 50,000 to 1 in 100,000), and infection at the phlebotomy site is rare. Both are easily treated and have little impact on the donor's health.