BACKGROUND: Recently, joint replacement arthroplasty has been increasing. We report retrospective study on preoperative assessments, anesthetic managements, and postoperative complications of patients with total knee replacement arthroplasty (TKR) or total hip replacement arthroplasty (THR). METHODS: Four hundred ninety-seven cases of TKR or THR operations were investigated. Age, body mass index, operation time, total input, total output, blood loss, transfusion, and complications with corresponding treatments were obtained from chart review and anesthesia records, and statistically analyzed. RESULTS: In 497 patients, most patients (91.5%) suffered arthroplasty under regional anesthesia. 78.0% of patients had one or more coexisting diseases, where hypertension was the most common. Blood loss and transfusion were more in THR than TKR during the operations (P < 0.05). But, TKR developed more blood loss after operation than THR because of the tourniquet usage, and especially in both TKR, blood loss reached approximately up to 47.8% of the estimated blood volume on the operation day. Postoperative complications were observed mostly on the operative and postoperative first days. Common complications were itching, nausea and vomiting, and hypotension which had no significant differences between anesthetic types. CONCLUSIONS: We concluded that anesthetic types for arthroplasty did not give statistically significant difference in postoperative complications. The blood loss was extremely high that it compromised the elderly patient with coexisting diseases. More surgical complications were observed in both TKR cases than in unilateral TKR cases. There must be precise preoperative assessment of health status and intensive postoperative management in the operative day.