138 patients undergoing hip arthroplasty for acute femoral neck fracture were randomized to receive either intravenous tranexamic acid (TXA) or placebo intraoperatively. The purpose of this study was to assess the efficacy of TXA for reducing blood loss and the incidence of blood transfusion, as well as to compare the complication rates between groups at 30- and 90-day follow-up. The results displayed a significantly lower calculated blood loss in the TXA group when compared to the placebo, and a non-significant difference between groups in transfusion requirement. Adverse events were not observed to significantly differ at 30- and 90-day follow-up.