OBJECTIVES: To evaluate venous thromboembolism (VTE) prophylaxis pattern for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the context of Brazilian health care system. METHODS: Retrospective medical chart review study of patients undergoing elective TKA or THA in 2010.  All charts were from either one public or two private hospitals in São Paulo, Brazil. Patients were 18+ years old, and excluded from the study if antithrombotic drugs were used prior to surgery. Descriptive analysis was performed through frequency distributions and mean/standard deviation (SD). RESULTS: From a total of 233 patients, 215 (92.3%) were included in the study: 121 (56.3%) TKA and 94 (43.7%) THA. Mean age was 68.2 (SD 9.8) years and 75.2% were female in the TKA group while, in the THA group mean age was 56.3 yrs (SD 15.6) and 53.2% were female.. From the public hospital, 71/81 (87.7%) patients received drug prophylaxis, being enoxaparin the choice of treatment. Enoxaparin onset mean time was 29hs after both surgery types. Mean inpatient treatment duration was 3 (TKA) and 4 days (THA). In private hospitals 132/134 (98.5%) received prophylaxis. Treatment of choice was enoxaparin in 130 (98.5%), while dabigatran and compression stocking in one case each. Compression stocking represented adjuvant prophylaxis in 16.7%. Onset mean time was 20hs after TKA and 17hs after THA for enoxaparin while 46hs for dabigatran. Mean inpatient treatment duration was 4  days(enoxaparin) and 3 days (dabigatran). CONCLUSIONS: The intra-hospitalar prevention rates of VTE in this study is within international (ENDORSE 2008), practice, while with lower rates in the public. There are uncertainties that outpatients received the same level of VTE prophylaxis. It is important to continue the awareness of the clinical and economic impact of VTE after orthopedic surgery, mainly in the outpatient care.