Pediateric patients who undergo posterior spinal fusion surgery to correct scoliosis often require multiple blood transfusion. Tranexamic acid is a synthetic antifibrinolytic drug that reduces transfusion requirements in cardiac surgery and orthopedic surgery. This study evaluated the efficacy of prophylactic administration of tranexamic acid to reduce perioperative blood transfusion requirements. 50 patients were enrolled in this study, aged 8 to 12 years. They were randomized to tranexamic acid group (initial dose of 10 mg/kg given intravenously over 15 minutes. A maintenance infusion of tranexamic acid 1mg/kg/h was initiated upon completion of the initial antifibrinolytic dose and continued until skin closure. In the control group lactated Ringer's solution was used in the same volume timing and rate of infusion as in the tranexamic acid group. Perioperative management was standardized. The total amount of blood loss and blood transfusion in the perioeprative period was significantly reduced in the tranexamic group (P=0.005). The fibrinogen concentration was significantly higher and the fibrinogen degradation products values were significantly lower in the tranexamic group. The administration of prophylactic tranexamic acid in patients undergoing spinal fusion for scoliosis has the potential to reduce perioperative blood loss and consequently blood transfusion.