Abstract: Transfusion related acute lung injury (TRALI) is a leading cause of transfusion related death. It is helpful to prevent and cure TRALI by understanding the potential mechanism of TRALI. Based on causative factors, it is divided into antibody mediated TRALI and non-antibody mediated TRALI; the former is caused by the passively infused endogenous antibodies, and the latter is mediated by the soluble molecules andcellular components from blood products.This review focuses on mechanisms of non-antibody mediated TRALI which include biological response modifiers accumulating during storage of red blood cells (RBCs) and platelets (PLTs), as well as changes in morphology and function of aged PLTs and RBCs, and the current research progress, so as to provide theoretical direction for clinical practice.