Hemarthrosis was found the most common complication after arthroscopic anterior cruciate ligament (ACL) reconstruction, which is associated with poor outcomes and poor patient satisfaction. To prevent the negative effects of these complications due to hemarthrosis, many different methods were developed such as suction drains, use of tourniquet, cold application, and bandages. The use of tranexamic acid (TXA) shows promising effects on reducing hemarthrosis and improved functional outcomes postoperatively; however. What method of administration, timing, and dosing is still controversial. The rate of venous thromboembolism (VTE) after ACL reconstruction was found higher than routine arthroscopic procedures. Although recommendations for thromboprophylaxis are still controversial, routine thromboprophylaxis is not recommended after arthroscopic ACL reconstruction in the absence of risk factors. It is showed that TXA does not increase VTE in patients that have no risk factors or history of thromboembolic events.