BACKGROUND Myomectomy remains a common surgical procedure in our environment for the management of symptomatic uterine fibroid. It is associated with significant intraoperative blood loss with an increased risk for blood transfusion. Different techniques are being used to manage blood loss during myomectomy with uterine tourniquet being the more popular technique in our environment. Tranexamic acid is an antifibrinolytic agent that has been evaluated in surgical patients to reduce blood loss. Its use during myomectomy may prove to be an effective means of reducing blood loss. AIM: To determine the effectiveness of intravenous tranexamic acid administration in reducing intraoperative blood loss in women undergoing myomectomy. METHODS: This was a randomised, placebo controlled, parallel designed double blind trial, carried out amongst women who had abdominal myomectomy in Federal Medical Centre, Owerri from July 2019 to October 2020. Seventy consenting women were randomly allocated at a ratio of 1:1 and received 1 gram of intravenous tranexamic acid (n = 35) and normal saline (n = 35) as placebo before the onset of surgery. Intraoperative blood loss was estimated using the gravimetric method.