We evaluated the effects of the drain-clamped method with tranexamic acid, a fibrinolytic inhibitor, for reducing blood loss during cementless total knee arthroplasty (TKA). TKA was performed on both knees of all subjects, utilizing the drain-clamped method with intra-articular infusion of tranexamic acid for one knee and intra-articular infusion of saline for the other. The knees were compared for the amount of postoperative blood loss, which was significantly less in knees with tranexamic acid infusion (353 ± 156ml) than those with saline (628 ± 221ml) (p<0.001). The drain-clamped method with intra-articular infusion of tranexamic acid is simple, inexpensive and effective for reducing the amount of blood loss in cementless total knee arthroplasty.