Sixteen randomized controlled trials (RCTs) were included in this meta-analysis evaluating the efficacy and safety of intravenous tranexamic acid in total hip arthroplasty. All included trials were placebo controlled. Results demonstrated significantly lower blood loss - including intraoperative blood loss, postoperative blood loss, and total blood loss - and transfusion rate with IV TXA versus placebo. The incidence of deep vein thrombosis was significantly higher following administration of IV TXA, but no significant differences between IV TXA and placebo were found for the rate of pulmonary embolism.