One of the most significant safety concerns in the automation of extracorporeal blood treatments such as dialysis is the risk of blood leakage. Such systems draw blood at such a high rate that a loss of integrity in the blood circuit can be catastrophic. The most reliable leak detection method known is the detection of infiltrated air in the blood line, but this only works in blood lines under negative pressure. According to the invention, a leak detector for return lines is provided by periodically generating a negative pressure, which may be brief or at a 50% duty cycle, in the blood return line to draw air into it and thereby reveal the leaks using an air sensor. Although the return line is ordinarily under positive pressure, during the negative pressure cycle, the blood return line draws air through any leaks or disconnects. If air is detected, the system is shut down and an alarm generated.