Objective A retrospective analysis was made on the influence of tranexamic acid (TXA) on intraoperative blood loss and blood transfusion volume of children patients during epilepsy surgery. Methods Children patients that received epileptic foci resection from January to December 2017 were included in the study and they were divided into group N1(aged 3 and below),group N2(more than 3 years old), group TXA1(aged 3 and below) and group TXA2 (more than 3 years old) according to the using condition of tranexamic acid. The erythrocyte, hematocrit, hemoglobin, hematoblastic changes of children from all groups before and after surgery were compared and the difference in intraoperative blood loss, urine volume, blood transfusion volume, liquid transfusion volume, blood loss per kilograms and the proportion of blood loss in estimated blood volume were compared. Results The difference in height, weight, length of surgery, estimated blood volume, urine volume, transfusion volume between four groups had no statistical significance. The intraoperative blood loss, transfusion volume, blood loss volume per kilogram and the proportion of blood loss volume in estimated blood volume of group TXA1 were all lower than that of group N1 (P<0.05). The intraoperative blood loss, transfusion volume of group TXA2 were lower than that of group N2 (P<0.05).The postoperative erythrocyte, hematocrit, hemoglobin, blood platelet of patients from group TXA1，group N2 and group TXA2 were lower than that before surgery (P<0.05); the postoperative erythrocyte, hematocrit, hemoglobin of patients from group TXA1 were lower than that of patients from group N1 (P<0.05). Conclusions Tranexamic acid can effectively reduce intraoperative blood loss and blood transfusion volume of child patient during epilepsy surgery.