FDA recommends blood donor screening for babesiosis in high-incidence states. Babesiosis, a tick-borne zoonosis, is known worldwide, but the highest reported prevalence is in the United States, primarily in the Northeast. The first case of babesiosis transmitted via blood or blood product transfusion was reported in 1980, and babesiosis became a notifiable disease in 2011. Between 2011 and 2017, an average of 1,628 babesiosis cases per year were observed in 26 states. Clinical severity can range from asymptomatic or mild to severe, lasting from one week to six months in transfusion recipients. Some patients have died. The Food and Drug Administration (FDA) now has sufficient data on incidence and prevalence affecting the potential donor population to issue recommendations for blood donor screening and testing in 14 high-incidence states and the District of Columbia. Read the full recommendations at http://www.fda.gov/media/114847/download.