Introduction: The aim of our study is to compare efficacy of  3 doses of intravenous (IV)  Tranexamic acid (TXA) versus combined  IV and intraarticular TXA in reducing blood loss and transfusion requirement in patients who underwent primary total knee arthroplasty. Methods: Group A patients were administered 3 IV doses of TXA. Group B patients were administered 1 gram of  IV and 2 grams of IA dose. Results: The mean 48 hrs drain collection was 238.33 ml in group A and 149 ml in group B. Mean hemoglobin drop is 2.39 gm% in group A and 1.74 gm% in group B.  Post operative blood transfusion was required in 12 patients (40%) of group A and 5 patients (16.67%) of group B. Conclusion: IA with IV  TXA is more beneficial than  IV TXA in reducing blood loss in primary total knee arthroplasty.