Objectives: To assess efficacy of topical tranexamic acid in reducing intra–operative blood loss in open myomectomy surgeries. Materials and methods: 100 women who underwent open Myomectomy were randomly divided into two groups. The first group received 2 gm topical tranexamic acid applied on myoma bed after myomectomy and the second group received topical placebo. Results: Topical tranexamic acid application significantly reduced intra–operative blood loss compared to placebo (305.24 ± 56.21 ml vs 523.57± 62.38 ml) and it was statistically significant (P < 0.0001). Conclusion: Topical application of tranexamic acid significantly reduced intra–operative blood loss during open Myomectomy.