ABSTRACT Objective: Describe the patterns of therapy for prophylaxis of venous thromboembolism and costs related to hospitalization of patients undergoing total joint arthroplasty within the context of the Brazilian health system. Methods: A retrospective study of patients undergoing arthroplasty in 2010 in a public hospital and two private hospitals in the city of São Paulo . Data collection was conducted by reviewing the medical records before surgery . Costs were estimated based on the use of health care resources during hospitalization , and the unit cost of each resource obtained from official price lists of Brazil . Descriptive analysis was performed using frequency and mean ( standard deviation ) according to the type of health care ( public or private ) . Results: A total of 215 patients were evaluated, Approximately 88 % and 98 % of patients from public and private health services , respectively , received some form of VTE prophylaxis , enoxaparin is the drug most widely used in both systems . The total cost of prophylaxis was R $ 1,873.01 ( AUD $ 26.38 per patient ) in the public service and R $ 21,559.73 ( R $ 163.33 per patient ) in the private service. For patients who develop thrombosis , the average cost of hospitalization was R $ 6,210.80 and R $ 43,792.59 per patient in public and private health services respectively . Conclusion: The thromboembolism prophylaxis in patients undergoing joint arthroplasty is most commonly used in the private health service than the public , although they are elevated in both services . The cost per patient with thrombosis during hospitalization was higher than the total cost of prophylaxis , suggesting how health services could save with the use of prophylactic regimens for all patients , and theoretically avoid one case of VTE .