Perioperative bleeding and blood product transfusion can increase the incidence of com-plications and mortality in patients.Optimizing blood management strategies can reduce perioperative risks,improve outcomes,and reduce healthcare costs.Prophylactic use of tranexamic acid(TXA)is an important component of perioperative blood management(PBM)strategies.TXA is an antifibrinolytic agent that com-petitively inhibits the activation of plasminogen,reducing surgical or traumatic bleeding and subsequently the amount of transfused blood during the perioperative period.It has been widely used in various types of surgeries in adults.However,experience in using TXA in the perioperative period in children is mostly based on adult data,and there are fewer pharmacokinetic studies on the use of TXA in children.The precise use of TXA in children has not yet been fully clarified.This article focuses on children and provides a review of TXA's pharmacological properties,methods of use in the perioperative period in children,and adverse re-actions.It aims to provide guidance on how to use TXA in perioperative blood protection in children and re-duce its complications.