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In most orthopaedic operating rooms, providers are routinely exposed to ionizing radiation associated with the use of fluoroscopy. There have been several reviews addressing the amount of radiation the primary surgeon is exposed to, but to the best of our knowledge, there has not been a systematic review of the amount of radiation to which the first assistant is exposed. We conducted a systematic review of the PubMed database to find studies measuring the amount of radiation exposure to providers in the orthopaedic operating room. Ten studies were included in the review. The results showed that, generally speaking, radiation doses for the first assistant were lower than the recommended occupational exposure levels. However, the amount of radiation that the first assistant is exposed to can vary depending on several factors, including use of personal protective equipment, distance from the C‐arm, and the role that he or she takes during the surgery. Although it appears that current fluoroscopic technique, when combined with proper radiation precautions, provides appropriate safety for first assistants, additional long‐term studies would be beneficial to determine the effects of the cumulative amount of radiation exposure.