Recently, studies have reported that increased level of red cell distribution width (RDW) is associated with deep vein thrombosis (DVT). We are aiming to evaluate the validity of RDW in DVT in patients undergoing total joint arthroplasty (TJA). A total of 110 patients (55 patients with DVT and 55 control individuals undergoing TJA) were included in this retrospective cross-sectional study. Age, sex, RDW, red blood cell count, D-dimer, hematocrit and hemoglobin levels of patients were matched. The relationship between RDW and DVT has been estimated. There is no statistical difference of RDW levels between the DVT group and the control group (13.12 ± 0.12 vs. 13.08 ± 0.13; P = 0.84). Pearson's correlation analysis showed that there were no significant associations between RDW and other referral groups. Logistic regression analysis indicated that RDW, red blood cell count, hemoglobin and hematocrit were not associated with DVT. Meanwhile, age, sex and D-dimer were independently associated with DVT. The receiver-operating characteristic curve and area under the curve demonstrated low accuracy of RDW in predicting DVT. Although D-dimer may identify the risk of venous thrombosis, the specificity and sensitivity were low. Preoperative level of RDW does not show predictive value for diagnosis of DVT in patients undergoing TJA.