Abstract [Objective] To compare the effect of three drainage methods after total hip arthroplasty (THA) on postoperative blood loss. [Methods] From January 2018 to March 2022, a total of 150 patients who underwent THA treatment in Lu'an Hospital affiliated to Anhui Medical University were divided into three groups according to the randomized numerical table method, with 50 cases in each group. All three groups were clamped early for 4h after surgery, and were connected to different ways of drainage after clamping, including negative pressure drainage in the negative pressure group (NPG), atmospheric pressure drainage in the atmospheric pressure group (APG), and positive pressure drainage in the positive pressure group (PPG) by elevating the middle part of the drainage tube. The clinical results and test indexes were recorded and compared among the three groups. [Results] The surgery was completed successfully in all three groups, and the differences in the preoperative and intraoperative clinical data of the three groups were not statistically significant (P>0.05). The total postoperative drainage volume and hidden blood loss in the PPG were significantly lower than those in the other two groups (P<0.05). At the corresponding postoperative time points, the differences in postoperative incisional pain VAS scores and hip circumference among the three groups were not statistically different (P>0.05). There was no statistically significant difference in the levels of Hb, Hct, and RBC among the three groups before surgery (P>0.05), and the difference among the three groups was statistically significant among the three groups in the 2d postoperative period (P<0.05), and the PPG was significantly higher than the other two groups (P<0.05). Postoperative blood transfusion rate and incision healing grade of patients in the three groups had no statistically significant differences among the three groups (P>0.05). [Conclusion] The use of early clamping for 4h combined with positive pressure drainage with mid-height elevation of the drain after THA was effective in reducing postoperative blood loss without increasing the incisional pain and hip swelling, is a simple and effective drainage method.