Introduction: Patients undergoing Total Knee Replacement (TKR) is increasing for the past few years. Thesafety and efficacy of bilateral simultaneous TKR has been an area of concern to most of the Orthopaedic surgeon. We used the Modified Enhanced Recovery for this study to evaluate the functional results to assess the early complications including mortality occurring after surgery. Materials and Methods: This is a prospective study of 100 knees (25 bilateral simultaneous TKR and 50 single knees) were included, managed between March 2016-February 2023. Preoperative, Intraoperative and Postoperative variables were analyzed at 2 weeks, 4 weeks,90 days, 6 months and at 2 years. Results: Average age of participants was 64.5 years. Preop oxford knee score improved from 17.75 to 46 in two years. Average blood loss was 340 ml and total operative time was 168 minutes, patients stayed 5.8 days in hospital, no readmission/ infection. Two patients had deep vein thrombosis and four patient had urinary tract infection, most of the patientsneeded blood transfusion. Higher VAS and OKS preoperatively correlated for postoperative improvement. Conclusion: Bilateral simultaneous TKR yields decreased hospital stay, improvement in OKS, VAS score, one time anaesthesia risk, one-time hospital admission and lesser follow-up visits and has cheaper cost of surgery, fast recovery and decrease in overall morbidities. Hence, it could be chosen in prudently selected patients with bilateral knee osteoarthritis.