Children with osteogenesis imperfecta (OI) often require operative management to correct limb and spinal deformities. The authors reviewed the postoperative courses of 22 children with OI and compared the febrile responses of these children with those of matched subgroups within a published historical control (8). The subgroups were matched for perioperative conditions including the magnitude of surgery, estimated intraoperative blood loss, transfusion status, age, and gender. In all subgroups examined, the patients with OI exhibited a significant increase in total febrile response (TFR) compared with those in the historical control group. Within the OI group, TFR correlated with estimated blood loss and magnitude of surgery. There were three fever workups in the OI group with no evidence of infection found. In children with OI, fever workups and delays in hospital discharge should be avoided if physical signs of infection are absent.