Hepatitis B virus (HBV) presents a higher residual risk of trans mission by transfusion than hepatitis C virus (HCV) or human immunodeficiency virus (HIV). While most infectious blood units are removed by screening for hepatitis B surface antigen (HBsAg), there is clear evidence that transmission by HBsAg-negative components occurs, in part, during the serolo gically negative window period, but more so during the late stages of infection. To encourage voluntary blood donation should be the first step of prevention. To reduce the risk of transfusion-associated hepatitis B, test for anti-HBc immunoglobulin M may be included in routine screening of donors' blood, as it has been proved to be an excellent indicator of occult HBV during window period. However, awareness and education of donors regarding the modes of HBV transmission, a stringent one-to-one donor screening and increasing the voluntary donor base should also be implemented to minimize the rate of transfusion-associated hepatitis B.