This study in Alexandria, Egypt was conducted to investigate the distribution of different hepatitis B virus (HBV) markers in apparently healthy blood donors who were hepatitis B surface antigen (HBsAg) negative, and to determine the major independent risk factors. Evidence of past exposure to HBV was found in 148/508 screened donors (29.1%). The most prevalent marker was anti-HBc in 124/508 donors (24.4%), half of whom (63/124) showed anti-HBc only. Anti-HBs prevalence was 15.9%, combined anti-HBc and antiHBs was 12.0% and anti-HBe was 5.7%. Independent risk factors associated with the presence of at least 1 marker were: being married (OR 3.82), history of blood transfusion (OR 3.04) and parenteral antibilharzial treatment (OR 2.49). Receiving a full HBV vaccination schedule was reported by 39 donors, but only 1 of them had isolated anti-HBs. The relatively high prevalence of HBV exposure necessitates solid infection control measures and adult vaccination programme awareness.