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Introduction: The vasovagal reaction (VVR) incidence is the most common adverse donor reaction poses a major risk to the donor's safety and a disincentive for repeat donation. The main objective of this study is to determine the efficacy of applied muscle tension (AMT) in reducing the VVR incidence among young blood donors aged 18-23 years old in Kelantan. Methods: A prospective comparative interventional study was conducted among 306 young blood donors that were equally assigned to AMT and non-AMT groups. Donors were assessed with Blood Donation Reaction Inventory at 30 minutes and 48 hours post blood donation. The subjects were followed-up on whether they make at least one donation attempt in the next six months. Results: Out of 306 young blood donors, the incidence of VVR was 24.8%. The AMT group showed a significant reduction in the VVR incidence rate compared to the non -- AMT group (p<0.001). There was no significant increment of donor return among AMT group than non -- AMT group upon follow-up in six months. In addition, female (p=0.002), low body weight (p=0.002), low estimated blood volume (p=0.033) and low systolic blood pressure (p=0.005), are important predictors of VVR. Conclusion: This study showed that AMT was an effective strategy to reduce the VVR incidence among young blood donors in Kelantan. Implementation of AMT is recommended to donors with high risk of developing VVR. [ABSTRACT FROM AUTHOR]