Tranexamic acid (TXA) is an anti-fibrinolytic agent with better antifibrinolytic activity than its counterparts. It is widely used for hemorrhages caused by fibrinolysis in reproductive, urinary, nervous, and athletic systems. For intraoperative and post-operative blood loss, preoperative and postoperative TXA can be used in addition to conventional blood management such as intraoperative autologous blood transfusion, controlled hypotension, and low temperature anesthesia. TXA is increasingly recognized by surgeons for its remarkable hemostasis and safety.