Residual risk is the risk that remains and cannot be completely eliminated after risk control and management measures have been implemented. This review summarizes the current status and progress of residual risk management in medical laboratories. It outlines the current application of commonly used risk management tools in clinical and transfusion laboratories for residual risk identification, reassessment, continuous monitoring, and improvement, and further reviews recent advances in disease-related residual risk in clinical laboratory testing and transfusion-related residual risk in transfusion safety. Available evidence suggests that residual risk management facilitates the ongoing identification of weaknesses in existing technologies and workflows, and promotes an expansion of risk management from internal laboratory control to patient safety and clinical decision support, thereby contributing to improved laboratory quality and transfusion safety.