18 publications (9 RCTs) were included in this systematic review and meta-analysis comparing the use of antifibrinolytic agents against placebo for the treatment of patients diagnosed with scoliosis undergoing correction surgery. The purpose of this study was to determine if the antifibrinolytic agents aprotinin, tranexamic acid (TXA), and epsilon aminocaproic acid (EACA) were effective at safely reducing blood loss and transfusion requirements. Efficacy analyses were conducted using only randomized controlled trials and safety analyses were conducted using all included trials. The results of this study support the use of antifibrinolytic agents in the setting of scoliosis surgery as all three were found to successfully reduce total blood loss, blood loss during and after surgery, perioperative blood transfusion volume, and transfusion rate (RCTs) while having no effect on adverse events (all studies).