One hundred patients with medial compartment knee osteoarthritis with varus deformity scheduled to undergo a high tibial osteotomy were randomized to receive intravenous tranexamic acid (TXA; n=50) or control (normal saline; n=50) for the management of blood loss. Outcomes of interest included drainage volume, blood loss, hemoglobin and hematocrit levels, and adverse events. Results revealed significantly lower total drainage volume and blood loss in the TXA group compared to control. Moreover, hemoglobin and hematocrit levels, as well as the change from baseline in hemoglobin and hematocrit levels, were significantly in favour of the TXA group. 2 cases of wound complication and 1 case of blood transfusion were reported in the control group; no complications were reported in the TXA group.