Introduction: Thromboelastography (TEG) and antifibrinolytic drugs are useful in the diagnosis and management of patients undergoing major orthopedic surgery to reduce perioperative bleeding and transfusion requirement. We described the effect of tranexamic acid on thromboelastography parameters. Methods: In 20 patients undergoing major orthopedic surgery, a dose of 20 mg/kg tranexamic acid followed infusion 1 mg/kg/h until the end of the procedure was administered. Two TEG were performed; baseline and a control at the end of the procedure. Thromboelastography effects are described. Results and Conclusions: No fibrinolysis was observed in the samples taken, however in 75% of patients increased the alpha angle suggesting a higher speed in clot formation; which might suggest a different mechanism of action of Tranexamic Acid as pro coagulant. Factors such as gender and age may modify the baseline TEG. The surgical time and the type of surgery are critical in bleeding and blood product requirement.