Maximizing hemostasis in total knee arthroplasty (TKA) remains a challenge today. Blood loss associated with knee joint reconstruction can lead to pain, joint stiffness, hemarthrosis, wound drainage, risk of infection, and slowed postoperative rehabilitation. This article reviews the current concept of hemostasis in TKA. The following topics are discussed in this article: (1) the types of blood loss in TKA, (2) the hemostatic effects of tranexamic acid (TXA) in TKA, (3) the advantages of the use of a tourniquet in TKA, (4) advantages and disadvantages of wound drainage after TKA, (5) benefits of cryotherapy in TKA and revision TKA, and (6) To compare the results of the use of TXA, platelet‑rich plasma, and fibrin sealant in TKA.