Introduction: One of the major problem associated with blood transfusions are Transfusion Transmitted Infections (TTIs). Accurate estimates of risk of TTIs are essential for monitoring the safety of blood supply. National AIDS Control Organisation (NACO) guidelines state that all donor’s blood samples should mandatorily be tested for Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Syphilis and Malaria. Aim: To estimate the seropositivity of HIV, Hepatitis B surface Antigen (HBsAg), HCV, Syphilis and Malaria among blood donors for tertiary care hospital of hilly region in Karnataka, India. Materials and Methods: This cross-sectional study was done from January 2012 to March 2018 in District Hospital Blood bank, Department of Pathology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India. The blood donors were screened with detailed history and physical examination according to Standard Operating Procedures (SOP) of Blood bank as per Guidelines for Blood donor selection and referral. Donor blood sample was subjected to screening investigations for TTIs diseases: HIV, HBV, HCV, Syphilis and Malaria. Data collected was tabulated in Microscoft Excel and results were expressed as percentage. Results: The study included total 9599 blood donors. The total number of male donors was 8985 and female donors were 614. There were 74 seropositive donors of which 71 (96%) were males and 3 (4.0%) were females. The total seropositivity rate of TTIs was 0.77% among which the incidence of seropositivity was higher in males as compared to females. There were 55 donors (0.58%) positive for HBV, eight donors (0.08%) positive for Syphilis, five donors (0.05%) positive for HIV, four donors (0.04%) positive for Malaria and two donors (0.02%) positive for HCV. Conclusion: Screening and better selection of donors by testing for TTIs are necessary to improve blood safety in the blood transfusion centre of hospital.