Introduction To explore the clinical efficacy of the enhanced recovery after surgery (ERAS) program in terms of blood management for primary hip arthroplasty patients. Method Ninety cases of total hip arthroplasty in our hospital from October 2020 to January 2022 were selected as the research objects, 45 cases as the control group, and 45 cases as the ERAS group. The control group was given routine care after operation, while the ERAS group was given ERAS management. The leucocytes, haemoglobin, platelets, albumin, D-dimer, C-reactive protein (CRP), total length of stay (LOS), and estimated blood loss after operation were compared between the two groups. Results The results showed that the Hb, TPO, and Alb of the ERAS group before operation, one day and three days after operation were significantly higher than those of the control group ( P  < 0.05). The WBC, CRP, and D-dimer in ERAS group were significantly lower than those in the control group ( P  < 0.05). The LOS in ERAS group was significantly less than that in control group ( P  < 0.05). Discussion ERAS scheme can reduce the loss of blood and nutrients from surgery in patients. WBC, CRP, and D-dimer in ERAS group were significantly lower than those in the control group. Humane care from ERAS programs can relieve patients’ anxiety to some extent. Conclusion ERAS management contributes to the recovery of hip function in patients undergoing THA, reduces blood loss during peri-operative period, and reduces the effect of operation on blood system.