Objectives: To present the impact of the various factors that affect mortality in pediatric patients who require red blood cell transfusion in the most diverse situations. Method: This is a systematic review, conducted according to the PRISMA methodology, linking randomized controlled trials and meta-analyzes of the last ten years in the English language, through a search in the electronic indexer PUBMED. The selected studies included patients of both sexes, without race restrictions, aged 18 years or less, submitted to a red cell transfusion procedure, regardless of the cause of transfusion, in articles published between 2006 and 2016. Results: 38 articles were searched, of which 34 were excluded after the selection screen, resulting in 4 articles for the analysis. The main results found reinforce the efficacy of transfusion restriction protocols compared to liberal protocols in relation to hemoglobin values. Also, no relationship was found between storage time and mortality. It has been identified that the main cause of mortality for chronically transfused patients is due to infections.Conclusions: Red blood cell transfusion in pediatric populations is a subject that needs further studies to measure the real impact on mortality.