120 patients, 10-18 years of age, scheduled for corrective instrumented posterior fusion for adolescent scoliosis were randomized to either intravenous tranexamic acid or placebo. Patients were assessed for blood loss parameters intraoperatively and over the first 24 hours postoperatively. Results demonstrated a significantly lower rate of clinically relevant blood loss, defined as >20mL/kg, in the TXA group compared to the placebo group. In addition, intraoperative blood loss, intraoperative cell salvage volume, postoperative drain volume, and incidence of transfusion were significantly lower in the TXA group compared to the placebo group.