A safe and sustainable blood supply is a necessary component of a successful healthcare system. However, across the world, countries face challenges in providing such a blood supply to their citizens. Sub-Saharan Africa, Tanzania being among of the countries, has the lowest donation rates worldwide, they only fulfill 20-50% of the blood needs (Mamaye 2013). This study aims at examining the barriers to sustainable blood system in Urban Moshi, looking the policies which are current in place and recommending the policies that would make the blood supply system more sustainable. Methodology: This was a qualitative cross sectional study conducted between 30th May and 24th June 2016, involving key stakeholders from Urban Moshi. Face to face interview and literature search from the internet was used to obtain information. Data was analyzed thematically. Results: As pointed out by different stakeholders, the factors that contributed to blood shortage in Urban Moshi were lack of education on blood donation and safety, misconceptions due to social-cultural and religious beliefs and lack of financial support from the government in conducting blood donation programs and establishing adequate blood bank infrastructure. Those who donated were either knowledgeable on donation or had a sick relative and they were supposed to donate for them. Conclusion and Recommendation: The problem of blood shortage has a large impact on the health care system. There is a need to change policies in place and implement the new policies in order to have a more sustainable blood system. Decreasing any unnecessary and inappropriate blood use, educating and sensitizing individuals to blood transfusion practices, maintaining the blood reserves, and increasing international aid will work holistically to strengthen the decentralized infrastructure by increasing appropriate blood usage, improving sustainability of blood storages, increasing VNRBDs, and generating financial savings.