Seventy-two patients scheduled for a primary, unilateral total hip replacement were randomized to receive a local administration of tranexamic acid (TXA) or intravenous administration of TXA at the same dosage. Outcomes of interest included the following: total blood loss, hidden blood loss, incidence of blood transfusion, hematocrit (Hct) and hemoglobin (Hb) levels, C-reactive protein (CRP) and interleukin-6 (IL-6) levels, incidence of deep venous thrombosis and pulmonary embolism. Hct and Hb levels were measured on post-operative days 1, 2, 3, 7, and 10; CRP and IL-6 levels were also measured at these timepoints in addition to 12 hours after surgery. The results revealed that total blood loss (p<0.001), hidden blood loss (p<0.001), and average blood transfusion (p<0.001) were statistically significantly in favour of the local TXA group compared to the IV TXA group. However, the incidence of blood transfusion was not statistically significantly different between the two groups (p=0.826). Hct, Hb, CRP, and IL-6 levels were statistically significantly higher in the local TXA group at all timepoints after surgery (p<0.05). The incidence of pulmonary embolism and DVT was not statistically significantly different between the 2 groups (p=0.555).