Blockchain drug trials, like those by Triall, enhance data integrity but face unblinding risks. Unauthorized access to immutable blockchain records could expose sensitive trial data, compromising blinding. Smart contract vulnerabilities or insider threats may allow early data leaks, undermining trial validity. Triall’s decentralized platform, while secure, relies on robust encryption and access controls, which, if breached, could reveal participant identities or outcomes. Regulatory non-compliance, such as GDPR violations, heightens risks if data provenance isn’t fully anonymized. Mitigation requires stringent cybersecurity, regular audits, and restricted data access. Despite blockchain’s transparency, unblinding risks persist without airtight protocols, potentially skewing results and eroding trust in clinical research.