Purpose of the Review <p>Blood cultures (BCx) are crucial for diagnosing bacteremia, but BCx contamination (BCC) can lead to false positives that prolong hospitalization and promote antibiotic use. The purpose of this review is to summarize evidence-based interventions to reduce BCC and improve patient outcomes.</p> Recent Findings <p>Diagnostic stewardship programs can optimize BCx use, ensuring BCx are obtained when diagnostically valuable. Proper BCx techniques, including correct timing, adequate volume, and paired samples, are essential. Thorough disinfection of the skin is important, but there is not a clear consensus on the superiority of one disinfectant over another. Bundled interventions using standardized kits and sterile technique have reduced BCC. Initial specimen diversion devices (ISDDs) have significantly reduced BCC. Although molecular-based rapid diagnostic testing shortens pathogen identification time, allowing quicker optimization of antibiotics, this has not been clearly shown to reduce the consequences of BCC. Education, surveillance, and feedback are effective, especially in coordination with phlebotomy teams, in reducing BCC rates, as demonstrated by multidisciplinary interventions. Antiseptic caps may reduce BCC from catheters, but whether ISDDs are useful in decreasing BCC in catheter drawn blood cultures is uncertain.</p> Summary <p>To improve outcomes, hospitals should aim for BCC rates below 1%. Various evidence-based interventions can be used to limit BCC including personnel education, training, and demonstration of competence; phlebotomy teams; monitoring and feedback of contamination rates; appropriate application of skin disinfection; blood culture kits; and use of initial specimen diversion devices. Future investigation should include better characterization of effective methods to limit BCC when BCx are obtained from vascular catheters.</p>