The optimal transfusion strategy in patients with acute myocardial infarction (AMI) and anemia may be influenced by sex differences in pathophysiology and cardiovascular outcomes. The Myocardial Ischemia and Transfusion trial (MINT) randomized patients with AMI and anemia to restrictive or liberal transfusion thresholds, but sex-stratified outcomes remain undefined. The objective was to evaluate whether the clinical effect of restrictive versus liberal red blood cell transfusion strategies differs by sex in patients hospitalized with AMI and anemia.