Perioperative blood management in total knee arthroplasty (TKA) is a critical measure for ensuring surgical safety and enhancing functional recovery. Recent evidence indicates that while minimally invasive techniques can expedite early postoperative rehabilitation, their effect on perioperative blood loss is limited. The use of tourniquets with restricted duration and low pressure can help reduce complication rates. Combined intravenous and topical administration of tranexamic acid is more effective in reducing blood loss than either route alone. Controlled hypotension and intraoperative blood salvage can significantly decrease the need for allogeneic transfusion and its associated risks. Integrating multiple strategies may further optimize perioperative blood management in TKA, however, individualized protocols still require confirmation by high-quality clinical studies.