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BACKGROUND: Tranexamic acid has been widely used in orthopedic surgery as a hemostatic drug. However, after arthroscopic surgery, the cartilage, tendons and ligaments are directly exposed to tranexamic acid. It is necessary to reiterate the importance of cartilage again. OBJECTIVE: To analyze the effect of topical tranexamic acid on cartilage through the existing experimental research and clinical data. METHODS: Related documents were searched in CNKI, WANFANG MED ONLINE, and PubMed by computer. The retrieval time was from the inception of the database to February 10, 2020. The Chinese and English key words were “tranexamic acid, arthroscopy, cartilage, toxicity”. RESULTS AND CONCLUSION: The dosage of clinical tranexamic acid is still based on the experience of physicians. There is great controversy regarding its safe administration concentration and exposure time. There is a lack of precise clinical guidelines. Based on the existing in vitro experiments, it was found that between 25-50 g/L, there should be a concentration that is safest for cartilage biological activity. Before there are further clinical evidences, it should be recommended that the local concentration of tranexamic acid should not exceed 25 g/L. When using tranexamic acid for washing, the mass concentration should not exceed 70 g/L. Regarding the most appropriate mass concentration of tranexamic acid for topical application, further research and clinical trials are still needed to better clarify its safety in topical use [ABSTRACT FROM AUTHOR]