A prospective study was done in the Department of Orthopaedics, Adesh Institute of Medical Sciences & Research, Bathinda to know the factors influencing blood loss and the need for transfusion in lower limb arthroplasty. Outcomes were assessed based on the patient’s age, gender, body mass index, tranexamic acid administration, tourniquet inflation, drain placement, use of navigation, preoperative haemoglobin level and postoperative haemoglobin level, and blood transfusion. Introduction: Postoperative blood loss is one of the most important factors in patients undergoing lower limb arthroplasty and has a direct effect on postoperative status. With an increasing number of patients undergoing hip or knee arthroplasty for various indications and with the subsequent requirement of allogenic blood transfusion, increased attention should be given to the management of blood loss which is a modifiable outcome that affects patient satisfaction and outcome. A haemoglobin of less than 10 g/dl before total joint arthroplasty implies a nearly 90% chance of requiring transfusion, decreasing progressively to 40–60 % between 10 and 13.5 g/dl, and 15–25 % beyond 13.5 g/dl, reflecting the inverse relationship between preoperative haemoglobin and allogeneic transfusion risk. Materials & Methods: This is a prospective study conducted at a tertiary hospital, in which 140 patients were included who underwent lower limb arthroplasty for various indications and were followed up over a period of 1 year after satisfying inclusion and exclusion criteria. Results: The mean drop in haemoglobin in BTKA was 2.49 + 0.93g/dl, in bipolar hemiarthroplasty was 1.60 + 1.17g/dl and in THA was 2.10 + 1.08g/dl, the mean drop in haemoglobin in unilateral knee replacement was 1.48 + 1.17g/dl. Conclusion: The drop in haemoglobin levels had a positive correlation with pre-operative haemoglobin levels. The estimated blood loss was significantly higher in hip arthroplasty compared to unilateral knee arthroplasty. In our study, the use of a suction drain doesn’t appear to be superior to no use of the drain.