Mexico with a population of 112 million in 32 federal states, has made great progresses in the lasts years in regulation, access and security of blood and components; actually the challenge is to reverse the reposition to voluntary blood donation system. The blood system counts with 555 blood banks and 4,342 transfusion services. 25% of the blood banks belong to the Ministry of Health, 15% to the Mexican Social Security Institute (IMSS) and 10% to the Institute of Security and Social Services for State Workers (ISSSTE), the blood banks of the Ministry of Defense, Navy and “Petroleos Mexicanos” constitute only 3% and more than 40% are private. Only 31 of them collect more than 10,000 units/year, 64 have an annually average collection between 10,000 and 5,000 and 101 collect over 2,000 and less than 5,000; 70% of the blood banks participated in the external quality control program. In 2011 the total country collection was 1,698,124 blood units, with an average increase of 50,000/year. PAHO’s rate of blood donors for every 10,000 inhabitants in Mexico is 148, indicating self‐sufficiency, but only 2·38% is obtained from voluntary blood donors. The IMSS collects more than 40% of the blood in country; but 99·7% is obtained by replacement donors. The frequency of transfusion transmission infectious diseases in blood donors was for HIV 0·31%, HBV 0·20%, HCV 0·60%, syphilis 0·47%, Chagas’s disease 0·46% and brucellosis 0·39%. The analyzed results highlight the need to promote voluntary blood donation, regionalization of blood services and to increase the participation in external quality programs in order to reduce the risks associated to blood transfusions in Mexico. The Ministry of Health promotes voluntary blood donations through external collects in universities, enterprises and embassies obtaining good responds. The “National Policy of Use of Blood and Blood Components” from 1993, was reviewed and updated including a mandatory establishment of a quality system based in GMP′s, participation in external quality programs, voluntary blood donation promotion, evaluation of the performance services information and hemovigilance reports.