Objective To observe the effect of general anesthesia with propofol and sevoflurane on the recovery quality of patients after total knee arthroplasty (TKA). Methods A total of 122 patients who originally underwent unilateral TKA at the First Affiliated Hospital of Anhui Medical University from August 2018 to July 2019 were selected. According to the random number table method, they were divided into two groups (n=61): a propofol group (group P) and a sevoflurane group (group S). Patients in group P were intravenously infused with propofol for general anesthesia and underwent femoral nerve and sciatic nerve block. In contrast, those in group S were inhaled with sevoflurane for general anesthesia and underwent femoral nerve and sciatic nerve block. Then, the EuroQol Five‑Dimensional Questionnaire (EQ‑5D) was used to evaluate the recovery quality one day before surgery, and at postoperative 1, 3, and 7 days (or on the day of discharge), and at postoperative 1 month and 3 months. Their EQ‑5D indexes were recorded. The Visual Analogue Scale (VAS) scores at rest and during exercise at postoperative 1, 2, 3, and 7 days (or on the day of discharge) were recorded. The incidence of postoperative delirium (POD) was assessed by the Confusion Assessment Method (CAM) within three days after surgery. Results There was no difference in EQ‑5D index between the two groups one day before surgery, at postoperative 1, 3 and 7 days, and at postoperative 1 and 3 months (P>0.05). The EQ‑5D index of group S was higher than that of group P at postoperative 1 month (P<0.05). There was no difference in VAS scores at rest and during exercise between the two groups at postoperative 1, 3, and 7 days (P>0.05), but group P showed lower VAS scores as rest and during exercise than group S at postoperative 2 days (P<0.05). There was no difference in POD incidence within three days after surgery and total incidence between the two groups (P>0.05). Conclusions Compared with propofol, general anesthesia with sevoflurane combined with peripheral nerve block can improve the recovery quality at postoperative 1 month. Compared with sevoflurane, general anesthesia with propofol combined with peripheral nerve block can relieve early acute pain after TKA. Both share a similar POD incidence.