To　assess　the　safety　and　efficacy　of　tranexamic　acid　(TXA)　for　decreasing　perioperative　blood　loss　in　cervical　laminectomy　with　lateral　mass　screw　fixation　and　bone　grafting　(CLF),　in　which　all　surgical　procedures　are　identical.　From　November　2014　to　April　2016,　we　performed　a　retrospective　comparative　analysis　of　119　patients　with　multilevel　cervical　spondylotic　myelopathy　who　had　undergone　a　CLF　from　C3　to　C6　in　our　center.　All　surgeries　were　performed　on　the　patients　using　a　consistent,　standard　procedure.　Patients　were　divided　into　control　(46)　and　TXA　(73)　groups　according　to　whether　or　not　they　had　received　TXA　treatment　before　and　during　surgery.　Demographic　profiles　of　patients　such　as　gender,　age,　body　weight,　height,　and　body　mass　index　were　collated　and　differences　between　the　2　groups　compared.　Preoperative　and　postoperative　hematological　data　in　addition　to　intraoperative　and　postoperative　blood　loss　were　compared　between　the　2　groups.　Additionally,　any　complications　of　TXA　were　also　evaluated　to　assess　safety.　There　was　no　statistically　significant　difference　in　demographic　traits　between　the　2　groups.　Intraoperative　blood　loss　in　the　TXA　group　(179.66　+/-　81.45mL)　was　significantly　lower　than　that　of　the　control　group　(269.13　+/-　94.68mL,　P　＜　0.001),　as　was　postoperative　blood　loss　(108.08　+/-　44.31　and　132.83　+/-　49.39mL,　respectively;　P=0.005).　Total　blood　loss　in　the　TXA　group　(287.74　+/-　115.40mL)　was　also　significantly　lower　than　that　of　the　control　group　(401.96　+/-　127.88,　P　＜　0.01).　No　major　intraoperative　complications　occurred　in　any　of　the　cases.　TXA　significantly　reduced　perioperative　blood　loss　in　CLF　with　no　major　side　effects.