Background and Objectives: Blood transfusion is a life-saving intervention but may cause nonfatal to fatal untoward events. Therefore, for safe blood transfusion, various adverse reactions need to be identified and steps should be taken to reduce such events. The aim of this study was to determine the incidence and analyze the types of acute transfusion reactions (ATRs) with associated factors. Patients and Methods: All ATRs reported to the transfusion medicine department from January 2016 to December 2020 were retrospectively reviewed and analyzed. The incidence of ATRs and its associated factors were assessed. Results: During the study period, a total of 39,070 units of blood were issued, out of which there was an incidence of 0.24% (n = 95) ATRs mostly seen in females and older patients aged above 60 years. Most common ATR was febrile nonhemolytic transfusion reactions (51.6%, n = 49), followed by allergic reaction (35.8%, n = 34). The most common symptom was chills and rigor (41.1%). The frequency of reactions was significantly higher with packed red blood cell transfusion (62.1%). Patients with previous transfusion history (n = 63, % = 66.3, P = 0.711) had more ATRs. Conclusion: By this study, the authors want to create awareness among health personnel involved in the transfusion chain is necessary to establish a proper hemovigilance system.