Objective Investigate the antihemorrhagic effect of intravenous perioperative tranexamic acid in hysterectomy for benign gynecological diseases. Study Design A prospective randomized case-control study was carried out in the Department of Obstetrics and Gynaecology, PGIMS, Rohtak, on 150 patients planned for hysterectomy for benign conditions. The women were randomized into two groups- Group I and Group II, with 75 subjects in each group. Group I was not be given any drug, while Group II was given TXA as intravenous bolus injection of 10mg/kg (maximum 1g) for 10 min about 30 min before incision. Unpaired ‘t’ test and ANOVA test were used to calculate the difference of means of quantitative variables. An association was significant if the p-value < 0.05. Results Intraoperative blood loss was reduced in the group given tranexamic acid preoperatively (mean loss 489.07± 279.248 ml) v/s the control group (mean loss 539.93 ± 211.08ml) (p<0.05). This result was particularly significant in the subjects who underwent vaginal hysterectomy (mean loss 364.58 ± 108.53ml in Group II v/s 278.91 ± 118.34ml in Group I; p<0.05). The incidence of transfusion of blood or blood products intraoperative to postoperative day seven was significantly reduced in the tranexamic acid group (0.47 vs. 0.23, P = .02). Conclusion The results show that preoperative intravenous tranexamic acid reduces the total blood loss irrespective of the route of hysterectomy and the number of perioperative transfusions. No incidences of serious adverse events occurred. Thus, tranexamic acid should be considered as a prophylactic treatment before benign hysterectomy.