PURPOSE: To investigate the expression and distribution of Rh phenotypes (C, c, D, E, e) among voluntary blood donors in a specific region of East China, to establish a regional Rh phenotype database, and to enhance the precision and efficacy of clinical blood transfusions. PATIENTS AND METHODS: A total of 28979 blood samples were collected from voluntary donors at a central blood station in East China between May 2023 and December 2023. An automated blood type analyzer was used to determine Rh phenotypes, which were then applied clinically for ABO and Rh blood type-matching in transfusions. RESULTS: Analysis of 28672 RhD-positive donors identified 13 RhD variants and eight Rh phenotypes, with the most common being CCee (42.69%) and CcEe (35.27%). Antigen frequencies were e (92.07%), C (87.85%), c (56.75%), and E (47.65%). Among 307 RhD-negative donors, seven Rh phenotypes were identified, with ccee (60.26%) and Ccee (29.32%) being the predominant ones. Antigen frequencies were e (99.67%), c (96.09%), C (34.53%), and E (6.84%). These findings supported 1834 ABO- and Rh- blood type-matching transfusions, but no significant difference was observed between ABO-compatible and dual-system compatible transfusions ( CONCLUSION: In this region of East China, the prevalence of RhD variants among voluntary blood donors was 0.045%. The predominant Rh phenotypes were CCDee and CcDEe, with the highest frequencies observed for the e and C antigens. And the frequency of Rh phenotypes in this region differs from related studies in other areas. It is essential to strengthen the establishment of a rare blood type database in East China to provide data support for clinical compatible blood transfusion.