Background: Bleeding is the most frequent complication of nasal surgery. The aim of this prospective study was to evaluate the effectiveness of tranexamic acid (TA), an antifibrinolytic agent, in reducing bleeding during and after nasal surgery. Methods: The study sample included 400 patients aged 18-60 years who underwent combination functional endoscopic sinus surgery with septoplasty and conchotomy. Two hundred patients were not given a hemostatic agent (control group) and 200 patients were administered 1 g of oral TA three times daily starting 2 hours before surgery, for 5 days. Bleeding was monitored during surgery and for 2 weeks postoperatively. Results: Patients given oral TA showed significantly less operative and postoperative bleeding compared with controls. No patients required additional packing, compared with five patients in the control group. Adverse reactions to TA were minimal, and they disappeared when the treatment stopped. Conclusion: TA is a safe and effective drug for the reduction of bleeding in nasal surgery. It may be recommended for routine use.