OBJECTIVE： To compare the clinical efficacy and safety of rivaroxaban and low molecular weight heparin calcium （LMWHA） in the prevention of deep venous thrombosis （DVT） after total hip arthroplasty （THA）. METHODS： A total of 100 THA patients selected from orthopedics department of our hospital as research objects were divided into control group and observation group according to random number table， with 50 cases in each group. Control group was treated with LMWHA injection 0.4 mL subcutaneously， qd； observation group was given Rivaroxaban tablet 10 mg orally， qd. Both groups received treatment on the first day after surgery， for consecutive 14 d. Coagulation indexes （PT， APTT， Fib， TT， D-D）， VAS score， the incidence of DVT and PE were observed in 2 groups. The postoperative bleeding volume and ADR as hematoma and gastrointestinal bleeding were compared between 2 groups. RESULTS： Before treatment， there was no statistical significance in coagulation indexes or VAS scores between 2 groups （P＞0.05）. After treatment， PT， APTT， TT and D-D levels， VAS scores of 2 groups were decreased significantly， while Fib levels were increased significantly； VAS score of observation group was significantly lower than that of control group， with statistical significance （P＜0.05）. There was no statistical significance in coagulation indexes between 2 groups （P＞0.05）. The incidence of DVT and PE in observation group were 8.00％ and 7.50％， which were significantly lower than 12.00％ and 4.00％ of control group， with no statistical significance （P＞0.05）. The postoperative bleeding volume of observation group was （298.31±52.18）mL， which was significantly lower than （327.40±54.20）mL of control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of hematoma or gastrointestinal bleeding between 2 groups（P＞0.05）. CONCLUSIONS： Rivaroxaban and LMWHA can significantly improve coagulation state， prevent the generation of DVT after THA. While rivaroxaban is better in shortening pain time without increasing the risk of ADR.