BACKGOUND: General anesthesia was known to induce hypercoagulable status during major orthopedic surgery. This study was designed to analyze effects on hemostatic reponse in patients receiving general or spinal anesthesia for total knee arthroplasty, using the thromboelastography (TEG). METHODS: Among women that were scheduled to total knee arthroplasty without both no medical or surgical history and no chronic systemic disorder, ten patients were selected at each group (general or spinal anesthesia). TEG was measured at 4 times around the each surgery (before skin incision after induction, before bone manipulation, after bone manipulation, 1 hour after operation). RESULTS: There was no difference statistically between two groups in first and second measures of TEG. But, significantly different r time, k time, alpha angle, and maximum amplitude was noted between two groups after bone manipulation and 1 hour after operation (P < 0.05). Conculusions: After the release of tourniquet following bone procedures the patients receiving general anesthesia had relatively high hemostasis compared with the spinal anesthesia group. This phenomenon was also noted in 1 hour after operation.