For a current systematic review and meta-analysis, researchers sought to establish the effectiveness and safety of tranexamic acid administration in patients undergoing Percutaneous Nephrolithotomy (PCNL). The study was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) declaration. Randomized comparative prospective studies were included in the systematic review and meta-analysis. The hemoglobin decline, bleeding problems, and transfusion rate were the key objectives. The operating time, stone-free rate, hospital stay, and total problems were all secondary objectives. A total of 2,566 papers were reviewed for the investigation. The meta-analysis included 6 randomized controlled trials (1,262 patients). In terms of primary endpoints, the tranexamic group had a lower hemoglobin drop than the control group, with a mean difference (MD) of 0.65 (P<0.0001); bleeding complications were less common in the tranexamic group, with an odds ratio (OR) of 0.32 (P< 0.00001); and the transfusion rate was lower in the tranexamic group, with an OR of 0.34 (P= 0.0007). Concerning the secondary endpoints, the operative time was shorter in the tranexamic group with an MD of 10.39 (P=0.0001), the meta-analysis of the stone-free status data revealed no statistical significance between the two groups with an OR of 1.58 (P=0.09), the hospital stay was significantly shorter in the tranexamic group with an MD of 1.38 (P= 0.005), and overall complications were less common in the tranexamic group than the control group with

The use of Tranexamic acid (TA) during surgery helped to reduce blood loss, bleeding problems, mean operational time, and hospital stay. In patients having PCNL, the use of TA appeared to be safe and well-tolerated.