Objective To search, evaluate, and summarize the best evidence of selection and management of blood transfusion access in adult patients, in order to provide an evidence-based basis for blood transfusion nursing practice.Methods We systematically searched relevant domestic and foreign databases and websites （UpToDate, BMJ best practice, Joanna Briggs Institute Evidence-Based Health Care Center Database, Guideline International Network, CINAHL, PubMed, CNKI, Wanfang, etc) to collect all the clinical decisions, guidelines, best practices, evidence summaries, system reviews and expert consensus reports on the selection and management of blood transfusion access.The search period was from the establishment of the database to December 2024.Two researchers independently evaluated the literature quality, extracted and summarized the available evidence based on the themes.Results A total of 9 articles were included, consisting of 1 clinical decision, 5 guidelines and 3 expert consensus reports.This study summarized 22 pieces of best evidence in relation to the following 5 themes:the selection of blood transfusion access, the use and management of blood transfusion devices, the use and management of ancillary equipment, personnel qualification and training, health education.Conclusion The study systematically and comprehensively summarizes the best evidence regarding the selection and management of blood transfusion access in adult patients.It is recommended that medical staff should select and apply the best evidence individually based on the patient′s vascular status, condition, as well as patient preferences, so as to improve the safety and standardization of blood transfusion.