Light reflectance of blood is a complex phenomenon affected by hematocrit and red blood cell (RBC) aggregation (rouleaux formation). According to the hypothesis that RBC rouleaux are aligned with the direction of blood flow, the spatial alignment of RBC rouleaux, as well as their size and quantity in the blood, may also affect light reflectance. The present study aims to investigate the effect of the spatial alignment and distribution of RBC rouleaux on light reflection using optical coherence tomography (OCT). Blood flow velocity and reflectance profiles in a rat jugular-femoral bypass loop were simultaneously measured using a Doppler swept-source OCT system at various incident angles from -30 to +30 deg. The reflectance profiles of flowing blood show nonmonotonous decay with a local negative peak at the center of the tube. The profiles vary depending on the incident angle. This angular dependence is stronger at a higher angle of incidence. The anisotropic reflectance of flowing blood is consistent with the hypothesis on the spatial alignment of RBC rouleaux.