HIV and HCV screening for recipients of labile blood products was recommended in France in 1996 by a ministerial circular. Conducted prior to transfusion and within the following four months, it aims to detect transfusion-related infections. However, questions regarding the actual implementation of the program and the reduction in transfusion-related viral risk led to a national evaluation. Its primary objective was to measure the screening completion rate, its effectiveness, and its cost-effectiveness; a secondary objective was to assess the accuracy of traceability and the mortality rate among recipients. A random survey of the 1,203,378 blood products distributed in France during the first half of 2001 yielded a sample of 1,115 hospital stays involving actual transfusion of homologous blood products. Data on the tests performed were then collected from hospital records. Traceability was considered accurate if the recipient’s last name, first name, and date of birth were identical in the hospital record and at the French blood establishment. A total of 1,092 records were reviewed. Pre-transfusion, 58.5% (95% CI [55.6–61.5]) of recipients had HIV and HCV testing, and post-transfusion, 30.5% (28.5–35.5%). Only 19.5% [16.6–22.6] of recipients who were alive at 6 months had both pre- and post-transfusion tests. During this period, no cases of HIV or HCV transmission via transfusion were reported in France. The accuracy rate of PSL traceability is 96.3% [94.9–97.3]; furthermore, 35.8% [33.0–38.7] of recipients had died by six months. The factors influencing the implementation of comprehensive screening, analyzed using logistic regression, are the administrative region of the healthcare facility, its size (more than 300 beds), and its transfusion volume (less than 5,000 units per year). Current practice can detect 0.14 HIV and 0.05 HCV transfusion-related infections per year. Under current conditions of application, the cost of screening is estimated at 20 million euros per year, and the cost per detected case exceeds 100 million euros. Emerging risks are overlooked by the current screening system. The pre- and post-transfusion HIV and HCV screening currently in use does not meet any of the evaluation criteria, and its cost-effectiveness ratio is unfavorable.