Objective To investigate the safety and efficacy of combined use of intravenous and topical tranexamic acid in hip arthroplasty without drainage. Methods 142 patients with unilateral primary total hip arthroplasty were completed in our hospital from December 2016 to December 2020. 71 patients were treated with local tranexamic acid and drainage (drainage group), and 71 patients were treated with combined intravenous and topical administration of tranexamic acid without drainage (non-drainage group). Activated partial prothrombin time（APTT）,prothrombin time(PT), fibrinogen, D-dimer, hemoglobin, and hematocellular volume on the third day after surgery were compared between the two groups, as well as intraoperative blood loss, postoperative drainage volume, latent blood loss, total blood loss, the number of blood transfusions, the Harris score of the last follow-up, the time of the first postoperative visit and the time of postoperative follow-up, etc. Results There were no significant differences in the postoperative activated partial prothrombin time, prothrombin time, fibrinogen level, D-dimer level, postoperative Harris score of affected limb and the last follow-up time between two groups (P > 0.05). The intraoperative blood loss, postoperative drainage volume, hidden blood loss and total blood loss in the non-drainage group were significantly lower than those in the drainage group (P < 0.05). Postoperative hemoglobin and hematocrit levels in the non-drainage group were higher than those in the drainage group (P < 0.05). Blood transfusion rate in drainage group (14.08%) was higher than that in non-drainage group (2.81%) and the difference was statistically significant (P < 0.05). Conclusion It is safe and feasible to combine intravenous and topical tranexamic acid in unilateral primary total hip arthroplasty without drainage.