[Objective] To compare the mid-term effect of tourniquet in total knee arthroplasty. [Methods] A retrospective analysis was performed on 98 patients admitted to our hospital from January 1, 2014 to June 1, 2015 who met the inclusion and exclusion criteria, including 48 cases in the tourniquet group (T group) and 50 cases in the non-tourniquet group (NT group).The length of hospital stay, operation time, intraoperative blood loss, number of blood transfusion cases, incision length and incision healing were compared between the two groups. KSS score, HSS score, and knee extension-flexion ROM before and 1, 3, 5 years after surgery; The average depth of bone cement penetration (6 anteroposterior and 4 lateral radiographs) and the vertical lines of the lower limbs were obtained at the points immediately, 1 year and 5 years after surgery. [Results] There was no significant difference in incision length and wound healing between the two groups (P > 0.05). The intraoperative blood loss of T group was (158.46±15.67) ml, which was significantly lower than that of NT group (260.58±33.09) ml;No significant postoperative complications were observed in both groups (one case of delayed healing in group T and one case of blood transfusion in group NT). There were no significant differences in KSS score, HSS score and knee extension-flexion ROM between the two groups (P > 0.05), but there were significant differences within the two groups (P < 0.001). There was no significant difference in the average depth of bone cement penetration between the two groups immediately, 1 year and 5 years after surgery, and there was no statistical significance in intra-group and inter-group comparison (P > 0.05). [Conclusions] Intraoperative use of tourniquet has no effect on mid - term joint function and prosthesis stability, and is conducive to rapid postoperative recovery, reduce the length of hospital stay.