Deep vein thrombosis (DVT) is a major risk following total knee arthroplasty (TKA). This prospective outcomes study evaluates the efficacy of enoxaparin 40 mg once daily for 7 days after TKA, by documenting symptomatic and asymptomatic outcomes using bilateral lower extremity duplex ultrasound upon hospital discharge and on postoperative day 21 (+/-2). In 60 extremities, duplex ultrasound demonstrated a DVT prevalence of 16.7% (10) on the day of discharge and of 11.7% (7) on postoperative day 21. No new DVT or propagation of distal to proximal DVT were noted. For this small cohort, enoxaparin 40 mg daily demonstrates effective prophylaxis for DVT in TKA patients.