Background: Tranexamic acid (TXA) is an amino acid derivative that exerts an antifibrinolytic effect. Previous studies showed that systemic TXA reduce for surgical patients bleeding in orthopedic and various nasal surgeries and postoperative edema and ecchymosis for surgical patients. Objectives: We aimed to evaluate the effect of TXA on postoperative ecchymosis and edema in patients who underwent excision of lipoma. Methods: Forty lipoma patients who underwent total excision between March 2017 and July 2019 were included. Retrospective chart reviews and photographic analyses were performed. In TXA group (n=20), 1g daily of TXA was administered for 5 days after surgery and in the control group (n=20), TXA was not administered. The severity of ecchymosis and edema at first visit after surgery was rated on 0-3 scale by two dermatologists. Results: The mean interval of first visit after surgery was 1.12±0.52 days (range: 1 ~ 4 days). The mean scores of ecchymosis evaluated using numeric scale were 0.5 ± 0.8 and 1.2±1.0 in the TXA and control group, respectively. Ecchymosis scores were significantly lower in TXA group compared with the control group (p＜ 0.05). But there was no statistical difference in edema scores between the two groups (0.5±0.6 in the TXA vs. 0.7±0.8 in the control group). Conclusion: We observed that the postoperative administration of TXA could decrease ecchymosis in patient who underwent excision of lipoma.