OBJECTIVES: Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) occurs most often in patients undergoing major joint arthroplasty and major surgical procedures (such as hip arthroplasty, HA or knee arthroplasty, KA). The prevalence of clinically relevant VTE, DVT and PE after hip and knee arthroplasty in nationwide database of Korea were 1.7%, 1.1% and 0.5%, respectively. The aim of this study was to compare the risk for VTE (including DVT and PE) between hip and knee arthroplasty in the Korean population. METHODS: A retrospective cohort study was conducted using nationwide claim registry obtained from the Korean Health Insurance Review and Assessment Service (HIRA), which includes medical claims records for 97.0% of South Koreans. We retrospectively identified patients who underwent HA or KA between January 1 and December 31 in 2010. VTE after arthroplasty were identified by diagnostic code (ICD-10: PE - I26, I26.99, DVT - I80, I82, I82.2) within 90days after surgery. Patients’ characteristics including sex, age and preoperative comobidities were defined using the HIRA database from 2007 to 2010. We compare the risk for VTE between hip and knee arthroplasty using logistic regression model in  patients without VTE history and VTE chemoprophylaxis use . RESULTS: 38,024 patients had HA or KA arthroplasty in Korea in 2010 (HA 11,908 patients, KA 26,116 patients). KA was associated with an increased risk of DVT [aOR=1.3; 95% CI=(1-1.7), p-value=0.048],  but KA was associated with a decreased risk of PE compared with HA [aOR=0.5; 95% CI=(0.3-0.7), p-value<0.001]. CONCLUSIONS: This study suggest that the risk of PE was high in HA rather than KA, but the risk of DVT was high in KA rather than HA. These results were due to differences in pathogenesis of DVT or PE.