ObjectiveTo estimate Eritrean national blood demand and demand satisfaction and to assess the associated trend of blood and blood products usage.BackgroundEstimating blood demand to determine collection goals is a challenge in many low‐income countries, including Eritrea.MethodologyThis study was a 5‐year survey of a representative sample of hospitals and was conducted in the National Blood Transfusion Center of Eritrea. Four referral hospitals in Asmara were selected. Blood bank registers and blood request papers were reviewed retrospectively from 2013 to 2017 to determine the number of components requested and the number and units issued. Data were calculated for annual trends in the difference between request and issue of blood products and the annual national estimate.ResultsThe largest met‐demand percentages were seen for International Organization for Cardiac Centre Asmara (IOCCA) (88.63%) followed by surgeries (79.49%), active bleeding (73.76%) and anaemia (67.82%), which were mostly requested for adult patients (>40 years). The mean value of requested products and issued products per patient were 2.50 (±0.972) and 1.81 (±0.839), respectively. The calculated correlation coefficient for the difference between demand and demand satisfaction was strong (R2 = 0.967), implying an increasing linear difference. It was estimated that nearly 72% of blood component demand was met over the 5 years.ConclusionEven though there was an increase in blood collection over years, the Eritrean National Blood Transfusion Services (NBTS) still falls short in satisfying the full demand.