OBJECTIVES: Patients undergoing total knee or hip replacement are at high risk of experiencing venous thromboembolism (VTE) - deep vein thrombosis (DVT) and pulmonary embolism (PE), therefore, the aim of this study was to estimate resource utilization and associated costs of VTE following TKR under SUS perspective. METHODS: Data analysis was conducted through a review of a government administrative claims database (DATASUS). A cohort of patients who underwent TKR surgery in the public healthcare system was defined (1/2010 - 9/2010) and followed for 6 months after surgery.  Data regarding total hospitalization costs were compared for patients who didn’t present complications with patients who presented VTE events. RESULTS: A total of 4736 patients were identified between January 2010 to September 2010 with average age of 65,6 years (SD 10,3), being 72.1% female. Mean hospitalization costs per patient were $BRL4,036    (SD 2,063) for the population analyzed. VTE episodes were experienced by 42 patients (0,89%, 32 cases of DVT and 10 of PE) and were associated with higher hospitalizations costs than patients without any complication:  $BRL3,919 (SD 1,811), $BRL4,581 (SD 2,362) and $BRL7,715 (SD 6,777) for patients without complication, DVT and PE respectively. CONCLUSIONS: Patients experiencing VTE following TKR surgery represents a significant economic burden for the Brazilian public health care system. Our study suggests that a patient who presents PE following TKR surgery can cost twice more than a patient without complications.