Blood transfusion accuracy is crucial for disease treatment and emergency rescue. Prior to a blood transfusion, it is essential to perform a number of tests to assure proper clinical treatment and reduce the risk of complications. Pre-transfusion testing refers primarily to the blood group, coagulation, and infection to assure transfusion safety and prevent cross-infection. Blood type, cross-matching blood, fibrinogen, viral hepatitis, human immunodeficiency virus, and syphilis are routine pre-transfusion tests. Immunoassay is the traditional clinical pretransfusion detection method. With the expansion of clinical treatment requirements from hospital to on-site treatment, new technologies, such as electrochemical sensing, microfluidics, and spectroscopy technology, are being developed gradually for rapid detection prior to blood transfusion. The development of technologies including colloidal gold immunity and biochips has facilitated the shift from large-scale laboratory equipment to portable testing for pre-transfusion screening. Further, the introduction of artificial intelligence technologies such as machine learning, biometric technology, and computer vision has contributed to the advancement of intelligent pre-transfusion testing. This article reviews the various application scenarios, benefits, and drawbacks of different pre-transfusion detection technologies, analyzes the application of a series of new technologies in pre-transfusion detection and its future development trend, and provides a reference for promoting the development of pre-transfusion detection and even rapid disease marker detection.