Understanding blood donation behaviours is pivotal to recruiting and retaining blood donors. Despite rich literature, this is the first study investigating the content and structure of motivations that underlie blood donation using a means-end chain approach. Based on soft laddering interviews with 227 respondents (31 first-time blood donors and 196 repeat blood donors) in the Klang Valley of Malaysia, we identified that their blood donation was primarily driven by the attribute 'help people', the consequences 'increase blood supply' (as perceived by first-time blood donors) and 'indirect downstream reciprocity' (as perceived by repeat blood donors) associated with the attribute and the belief that the consequences can lead to the fulfilment of the value 'humanitarianism'. Understanding of such hierarchical links between motivators is crucial in developing self-relevant communications. The resultant outcomes are likely to be more effective than the traditional approaches in behavioural change.