A 74-year-old man experienced an acute hemolytic reaction following transfusion of 4 units of red blood cells. The recipient was K negative, one of the transfused units was K positive, and another contained a previously undetected anti-K with an indirect antiglobulin titer of 512. Further investigation led to the discovery of a hemolytic transfusion reaction in a second K-negative patient who received a platelet transfusion containing 50 mL of plasma from the same donor. The clinical and serologic features of these two cases and five previously reported cases of hemolytic transfusion reaction due to interdonor Kell incompatibility are summarized.