Objective To investigate the clinical effect of rivaroxaban and enoxaparin on the prevention of lower deep vein thrombosis after arti-ficial knee joint replacement.Methods A total of 120 patients who ex-perienced first artificial knee replacement surgery were divided into two groups.And 12 h after surgery , 60 patients in treatment group were gi-ven oral rivaroxaban 10 mg · d -1 , 60 patients in control group received subcutaneous enoxaparin heparin 4000 IU · d-1.The treatment of two groups all lasted for 14 d.The incidence of deep vein thrombosis , bleed-ing, complications and long -term efficacy of patients between groups were compared.Results There were no statistical difference between treatment group and control group in terms of activated partial thrombo-plastin time ( APTT ) , blood platelets count ( PLT ) and D -dimer ( all P>0.05 ) .The incidence rate of lower deep vein thrombosis in treatment group was 11.67%( 7/60 ) and control group 15.00%( 9/60 ) , they had no significant difference ( P>0.05 ).There were no statistical difference between two groups in postoperative drainage , total amount of blood transfusion and hemorrhagic index ( all P>0.05 ).The incidence rate of petechiae in treatment group was 23.33%(14/60), and 18.33(11/60) in control group (P>0.05).There were no sta-tistical difference between two groups in visual analogue scale ( VAS) pain scores and swollen knee at first three days and seven days after operation (all P>0.05).There were no statistical difference between two groups in knee mobility and keen society score ( KSS) function scores during the follow-up half a year after operation (all P>0.05).The knee mobility and KSS function scores during the follow-up one year after operation in treatment group were higher than that in control group ( all P <0.05 ).Conclusion Rivaroxaban and enoxaparin had equivalent efficacy on the prevention of venous thrombosis after artificial knee joint replacement surgery.However, the long-term clinical effect of rivaroxaban was better .