【Objective】 To demonstrate the real incidence and clinical features of acute transfusion reactions (ATRs) and analyze its association with transfusion effectiveness. 【Methods】 The blood transfusion process of patients in the Hematology Department in our hospital from March 16, 2018 to March 16, 2019 was observed and followed up. The vital signs and clinical features were recorded, the clinical data and relevant laboratory examination results were collected, and the correlation between ATRs, clinical features and transfusion effectiveness was statistically analyzed. 【Results】 A total of 2500 transfusions were observed in the Hematology Department, out of which 138 patients developed 242 ATRs. The overall incidence of ATRs was 9.68% (95% CI, 8.52%~10.94%) and the incidence of ATRs during platelets transfusion was the highest. The clinical features of most ATRs were mild and no fatal consequences occurred. No significant difference was found in the association between transfusion effectiveness with ATRs in platelets and red blood cells transfusion (P>0.05). 【Conclusion】 None of the ATRs observed in this study resulted in serious consequences or had effect on the transfusion effectiveness. The characteristics presented in these reactions may provide certain references for clinical practice.