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ABO blood group antigens are surface markers on the red cell, and consist of proteins and carbohydrates attached to lipids or proteins. ABO antigens are widely expressed on the membranes of red cell and tissue cell as well as, in the saliva and body fluid. ABO antigens are synthesized by enzymatic reactions catalyzed by specific glycosyltransferases A and B enzymes that respectively add N-acetyl galactosamine and galactose to a precursor chain, the H antigen, by an identical α1-3glycosidic. Initial steps for biosynthesis of ABO antigens is began by addition of L-fucose on terminal galactose (Gal) of type 1 precursor, resulting in H antigen(Watkins, 1977). Subsequently, the A antigen is synthesized by enzymatic reactions catalyzed by glucosyltransferase (α1,3-N-acetyl-D-galactosaminyltransferase) which adds N-acetyl galactosamine to a precursor chain, the H antigen, and the B antigen is synthesized by enzymatic reactions catalyzed by α1,3-D-galactosyltransferase that adds galactose to H antigen. The genetics underlying the structures of ABO antigens are more complex because ABO antigens are generated by sequential action of a number of enzymes. The ABO gene encodes specific glycosyltransferases that add either N-acetyl galactosamine or galactose to the H antigen then converting it into the A or B antigen respectively. The gene encods ABO antigens is located at the long arm of chromosome 9q34.