The market for blood thrived in China for more than a decade, preying on rural villagers desperate for cash. Profit motives and unhygienic collection created an AIDS epidemic, where now up to 80 percent of adults in some villages are HIV infected. Today, illegal blood banks continue to operate in some areas. Moreover, better screening and blood testing do little to address the underlying cultural reluctance to give blood. This article examines what is at stake for blood donors in the circulation of blood through both the physical and the social bodies in China today. I argue that public health and social policy solutions require consideration of the symbolic meanings of blood and the body, kin relations, and gift exchange. China's HIV-contaminated blood procurement crisis demands a critical reexamination of the hidden processes embedded in a "circulatory system" that has inseparably bound the "gift of life" and a "commodity of death".