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Background and Objective: In spite of newer sensitive screening techniques, blood transfusion is still associated with a small risk of transmitting infectious diseases. A very important and efficient method of curtailing transfusion transmitted infections (TTIs) is notifying and counseling the TTI reactive donors. Materials and Methods: Totally, 4281 donations were screened for TTI, namely, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, by serology. All TTI reactive donors were retested and notified of their status by telephone or letter and called for repeat testing followed by face-to-face counseling and referral for treatment. Results: We evaluated 116 (2.7%) donors with reactive screening test results, i.e., 41 (1%) HBV, 61 (1.4%) HCV, 12 (0.3%) HIV, and 2 (0.05%) reactive for both HIV and HCV while none of donors were syphilis reactive. Only 35.34% (41) of donors responded to notification. The response from voluntary donors was comparatively less as compared to the replacement donors (34.6% vs. 41.7%). Around 22 (53.7%) of counseled reactive donors revealed history of high-risk behavior/factors which were not disclosed during donor registration and screening. Conclusion: In spite of strict donor screening and self-exclusion option, donors conceal their high-risk behaviors and continue to donate blood. It reflects the need to implement predonation counseling to extract the history of high-risk factors from the donors. Maintenance of privacy during donor screening, predonation education and counseling and postnotification counseling of reactive donors are recommended. National guidelines for notification of reactive donors need to be formulated.