National epidemiological surveillance of blood donors is conducted by the French Institute for Public Health Surveillance (InVS) and the National Reference Center (CNR) for Hepatitis B and C in Blood Transfusion (National Blood Transfusion Institute), in partnership with the French Blood Establishment (EFS) and the Armed Forces Blood Transfusion Center (CTSA). The objectives of this surveillance are to monitor the prevalence and incidence of blood-borne infections, identify potential new risk factors, and assess the residual risk of transmission of these infections through transfusion. It also contributes to the evaluation of donor selection and prevention policies. Analysis of data from the 2001–2003 period has highlighted several key findings. Prevalence rates are stable: 0.60 per 104 new donors for HIV, 8.0 per 104 for HCV, 1.8 per 104 for HBsAg, and 0.56 per 104 for HTLV. The incidence of HIV and HBV (1.0 per 105 person-years) is three times higher than that of HCV (0.35 per 105 person-years) and 11 times higher than that of HTLV (0.09 per 105 person-years). The residual risk of transmitting a viral infection through transfusion is very low: 1 in 3,150,000 donations for HIV, 1 in 10,000,000 for HCV, and 1 in 640,000 donations for HBV. Finally, the benefit of viral genomic screening is limited, as it has allowed for the exclusion of two HIV-infected donations and three HCV-infected donations over the first 30 months.