Abstract: OBJECTIVE To investigate the results of blood screening tests for voluntary blood donors in Shijiazhuang City from 2020 to 2024 and analyze the risk factors. METHODS A total of 1 034 914 blood samples were collected from the blood donors in Hebei Province Blood Center from Jan. 1, 2020 to Dec. 31, 2024. The hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), Treponema pallidum antibody (anti-TP), human immunodeficiency virus antigen/antibody (HIV Ag/Ab) and levels of nucleic acids of three types of corresponding pathogens (HBV, HCV and HIV) were detected for all of the samples. Multivariate logistic regression analysis was performed for the risk factors for unqualified tests of blood samples. RESULTS Among the 1 034 914 blood samples, 10 606(1.02%) were unqualified; 4 216(39.75%) were unqualified for ALT, 1 970 (18.57%) were tested positive for HIV Ag/Ab, 1 706 (16.09%) were tested positive for anti-TP, 1 072 (10.11%) were tested positive for HBsAg, and 867 (8.17%) were tested positive for anti-HCV; 775 (7.31%) were tested positive for there types of nucleic acids, 386 (3.64%) of which were positive for HIV, 214 (2.02%) were positive for HBV nucleic acid, and 175 (1.65%) were positive for HCV nucleic acid. Univariate analysis and multivariate analysis showed that the body mass index (BMI), residence registration, seasons, blood donation history and oversea travel history in recent 6 months were the influencing factors for the results of blood sample tests(P＜0.05). CONCLUSIONS The unqualified rate of blood samples is low among the voluntary blood donors in Shijiazhuang City from 2020 to 2024. The BMI, type of residence registration, seasons, blood donation history and oversea travel history are the key independent risk factors, which may provide significant bases for optimizing the recruitment of blood donors, screening strategies, and ensuring the safety of blood transfusion.