Tranexamic acid (TXA) has been hailed as a game-changer in bleeding management...but does the evidence really support its widespread use? In this episode, we dive into the research behind TXA across multiple clinical settings: trauma, surgery, postpartum hemorrhage, GI bleeds, intracranial hemorrhage, and more. We explore landmark trials like CRASH-2 and CRASH-3, discuss why small positive studies don’t always translate into meaningful patient outcomes, and unpack the nuances of timing, context, and risk. Join us as we separate hype from evidence and ask the big question...where does TXA truly belong in emergency medicine?