One hundred patients scheduled for surgical treatment of an intertrochanteric fracture with a proximal femoral nail anti-rotation system were randomized to receive tranexamic acid (TXA) or no treatment for the reduction of blood loss and need for transfusion. The primary outcome of interest was estimated total blood loss. Additional outcomes of interest included intra-operative and hidden blood loss, levels of hemoglobin and hematocrit, transfusion rate, number of units of blood transfused, drainage volume and the incidence of complications. Follow up was performed up to 1 month post-operation. Results revealed significantly lower estimated total blood loss, intra-operative blood loss and hidden blood loss in the TXA group compared to the control group. Hemoglobin and hematocrit levels in the first post-operative day were significantly in favour of the TXA group compared to the control group. Whilst the incidence of transfusion was significantly lower in the TXA group compared to the control group, there were no significant differences between the two group in the mean number of units of blood transfused. No significant differences between the two groups were observed in drainage volume or the incidence of complications.