Background. Armed conflict can disrupt blood collection, inventory management and distribution, placing continuity of essential transfusion services at risk.

Objective. To describe national blood-service operations and response measures during 39 days of armed conflict in Iran.

Methods. This retrospective comparative operational study used aggregated routine data from the Iranian Blood Transfusion Organization (IBTO) for 28 February–7 April 2026 and the corresponding 39-day period in 2025. Outcomes were donor presentations, whole-blood collections, first-time and female donors, interprovincial red blood cell (RBC) redistribution and national RBC inventory in days of supply.

Results. Donor presentations increased from 262 403 to 301 006 (14.7%) and successful whole-blood collections from 220 361 to 247 893 (12.5%). First-time donors increased by 63.9%, female donors by 79.6%, and interprovincial RBC redistribution by 97.9%. Mean national RBC inventory increased from 5.4 to 7.8 days of supply; it exceeded the 7-day operational reserve target on day 10 and remained above that target thereafter. In the supplementary operational summary, recorded expiry-to-production proportions were 0.032% for RBC, 0.089% for LRBC, 4.90% for platelets and 0.051% for FFP. Post-conflict donation counts varied by month compared with 2025.

Conclusion. During the conflict, IBTO sustained collection and redistribution activities while national RBC inventory increased above its operational reserve target. Available supplementary data describe recorded expiry but do not measure total wastage; aggregate post-conflict counts cannot establish the effect of donor deferral or clinical consequences.