Abstract:[Objective] To investigate the effects of enhanced recovery after surgery (ERAS) management on deep vein thrombosis(DVT) in total knee arthroplasty (TKA). [Methods] A retrospective study was done on 307 patients who received primary TKA and under-went preoperative and postoperative lower limb vascular ultrasonography in our hospital from July 2016 to June 2018. According to the doc-tor-patient discussion, 88 cases were divided into ERAS group, while other 219 cases were in the routine group. The clinical results, coagu-lation test and ultrasound consequence of the two groups were compared. [Results] The ERAS groups proved significantly superior to theroutine group in terms of operative time [(107.0±19.4) min vs (134.9±20.7) min, P＜0.001] and postoperative ambulation time [(27.8±11.5)days vs (70.6±11.0) days, P＜0.001], occurrence of symptomatic thrombosis during hospitalization [non/calf/whole lower limb/cardiopulmo-nary, (86/2/0/0) vs (196/15/8/0), P=0.046], and the incidence of confirmed thrombotic events (9.1% vs 19.6%, P=0.025). With regard to co-agulation assay, ERAS group were significantly lower than the routine group in postoperative D-D [(3.2±1.7) mg/L vs (3.8±1.7) mg/L, P=0.008] and FIB [(4.9±1.9) g/L vs (5.6±2.3) g/L, P=0.011]. Regarding to ultrasound, the ERAS was also significantly better than the routinegroup in distribution of thrombus [none/ intermuscular/ small vein/ large vein/ pulmonary artery, (80/2/6/0/0) vs (176/10/20/13/0), P=0.045]during hospitalization. [Conclusion] Perioperative ERAS management can effectively reduce the occurrence of DVT in primary TKA andcontribute to the prevention of thrombosis.