8 randomized controlled trials comparing restrictive blood transfusion and liberal blood transfusion were included in this analysis. The purpose of the study was to determine the effects of restrictive blood transfusion on the overall infection risk of orthopedic patients, as compared to liberal blood transfusion. Secondary outcomes included the specific risks of wound infection and pneumonia. Pooling of results revealed a significantly reduced risk of overall infection for patients who received restrictive blood transfusion compared to those who received liberal transfusion. No significant effect on secondary outcomes of wound infection or pneumonia were observed.