One hundred four patients with end-stage hip joint diseases undergoing primary total hip arthroplasty were randomized to receive intraoperative bone wax (n=52) or no bone wax (n=52). The primary outcome was total blood loss. Secondary outcomes included serum hemoglobin level, change in hemoglobin, thigh swelling (lower limb diameters), range of motion at discharge, length of postoperative hospital stay, and adverse events. Outcomes were assessed on postoperative days (POD) 1 and 3, and during follow-up at 3 weeks and 6 months. Overall, the results of the study revealed significantly lower total blood loss, smaller hemoglobin drop, and shorter hospital stays in the bone wax group. The study concludes that bone wax use effectively reduces blood loss without increasing adverse events and could be incorporated into routine perioperative blood-conserving strategies in THA.