Seven randomized controlled trials were included in this systematic review and meta-analysis to determine the effectiveness of erythropoietin in reducing the risk of exposure to allogenic blood transfusions in patients undergoing total hip and knee arthroplasty procedures. Outcomes assessed were the incidence of allogeneic blood transfusion, units of allogeneic blood transfused, the incidence of adverse events, and cost. The results of this meta-analysis indicated that erythropoietin significantly reduced the risk of exposure to allogenic blood transfusion in both THA and TKA procedures, without increasing the risk of thromboembolic and vascular events. The cost was only evaluated in one study and a pooled estimate could not be calculated.