Eight studies (4 RCTs and 4 nonRCTs) were included in this meta-analysis investigating the efficacy and safety of intraarticular tranexamic acid in primary total hip arthroplasty. Studies which compared topical administration of TXA to a group who received placebo, or not treated with TXA, were selected for inclusion. Meta-analysis demonstrated efficacy of TXA, with significantly lower total and postoperative blood loss, mitigated hemoglobin drop, and reduced transfusion need compared to control groups. There was no evidence of increased risk of thromboembolic complications (deep vein thrombosis and pulmonary embolism) with the use of intraarticular TXA.