Closed suction drains are still commonly used following orthopedic procedures. While empirical recommendations predominated until the 1980s,many randomized controlled studies concerning the use of drains have been conducted within the last 20 years. This article compares studies that have been performed in a prospective randomized manner.Numerous investigations have shown that there is no positive effect of suction drains with regard to long-term results in aseptic orthopedic surgery. This even holds true in the fields of endoprosthetic surgery and procedures that are associated with a high incidence of complications, e.g., bone grafting from the iliac crest.Moreover, there is evidence from some studies that septic complications are significantly higher in the suction drain groups.Evidence-based surgery should call for a very critical indication to use suction drains;however, the acceptance of this evidence is very low among surgeons up to now.