Arthropod-borne viruses (arboviruses) are a growing threat to global health. Complex vector–virus–host interactions lead to unpredictable epidemiological patterns. Difficulties in accurate surveillance including imperfect diagnostic tools impair effective response to outbreaks. With arboviral infections causing a wide spectrum of disease severity, from asymptomatic infection to fatal neuroinvasive and haemorrhagic fevers, the potential impact on blood safety is significant. Asymptomatic or presymptomatic individuals may introduce virus into the blood supply by donation, while recipients can potentially suffer severe consequences. Dengue, West Nile and chikungunya outbreaks have led to responses by blood transfusion services which can inform future planning. Reports of transfusion-associated transmission demonstrate the potentially fatal consequences of lack of haemovigilance. South-East Asia remains vulnerable to arboviruses with permissive climate and high levels of endemic transmission as well as the potential for emerging and re-emerging arboviral diseases. Resource limitations constrain the use of expensive technologies for donor screening. Continued surveillance and research will be required to manage the arboviral threat to the blood supply.