Tranexamic acid (TXA) has been used in different orthopedicdepartments to reduce blood loss, transfusions, hemarthrosis, wound formation, infections, and other related complications. Nonetheless, the role or efficacy of Tranexamic acid (TXA) in total ankle arthroplasty (TAA) is not precisely depicted. This systematic review aims to report the role or efficacy of Tranexamic acid (TXA) in total ankle arthroplasty (TAA). This study conducted to find out the role or efficacy of Tranexamic acid (TXA) in total ankle arthroplasty (TAA). Database searches were conducted for eligible studies from 26thFebruary 2002 to 26th October 2022. Clinical studies on the use of Tranexamic acid in total ankle arthroplasty (TAA) were included. The outcomes were projected blood loss, hemarthrosis, change in hemoglobin, wound infections, and complications. Eight studies met the inclusion criteria. In six studies, Tranexamic acid (TXA) was found to be effective in reducing wound formations, infections, and complications in total ankle arthroplasty (TAA). However, two studies reported the use of Tranexamic acid (TXA) in total ankle arthroplasty (TAA) as non-effective. Six studies reported on blood loss, in which, in 4 studies there was no significant difference in blood loss between patients that received Tranexamic acid (TXA) during total ankle arthroplasty (TAA) and the control group. However, in twostudies Tranexamic acid (TXA) was found to be effective in reducing blood loss. In conclusion, Tranexamic acid (TXA) is associated with reduced wound formations, infections, and complications in total ankle arthroplasty (TAA). Additionally, TXA does not significantly reduce blood loss in total ankle arthroplasty.