19 randomized control trials examining a total of 1114 patients who underwent primary unilateral total knee arthroplasty with the use of a tourniquet and tranexamic acid or placebo were included in this meta-analysis. The purpose was to compare blood loss, transfusions, and adverse events in patients treated with tranexamic acid or a placebo. The results suggest that tranexamic acid can effectively and safely reduce blood loss and the need for transfusions in TKA patients. Although the studies included in this meta-analysis were of relatively high quality, the sample sizes were small; therefore, further research is required to verify these results.