We examined whether a single 1-gram preoperative dose of tranexamic acid (TXA) was effective in reducing 1) allogeneic blood transfusion, 2) haemoglobin (Hb) decreases, and 3) perioperative blood loss following primary total hip arthroplasty (THA) and resurfacing hip arthroplasty (RHA). One hundred and thirty-two patients (88 THA, 44 RHA; 66M, 66F; mean age = 58.2 years) who received TXA were compared with a control group matched for starting Hb, body mass index (BMI), age and gender. For the THR, transfusion rates were 4.5% and 19.3% for the TXA and control groups, respectively (p = 0.001) with no difference for the resurfacing patients. The mean overall Hb decrease was significantly lower in the TXA treatment groups for both THA and RHA patients (p<0.0001 and p = 0.01 respectively). 1 g of tranexamic acid administered preoperatively significantly reduced the mean decrease in haemoglobin as well as risk of transfusion.