Objective To observe the effect of timely temperature-adjustment strategy versus routine heat preservation strategy on body temperature in patients undergoing bilateral total knee arthroplasty under general anesthesia, and to explore a safe and effective temperature management method for patients at high-risk of hypothermia. Methods Totally,98 patients undergoing bilateral total knee arthroplasty under general anesthesia were selected and evenly randomized into 2 groups.The timely temperature- adjustment strategy was applied in the intervention group, while routine heat preservation strategy was applied in the control group. Body temperature data were collected respectively at the time points of entry into the operating room, immediately after anesthesia induction, at the beginning of the operation, 40 mins, 80 mins, 120 mins into the operation, exit from the room. Bleeding volume, the time to emerge from anesthesia and incidence rate of postoperative shivering were also recorded. Results Patients′ body temperatures in both groups decreased gradually as the surgery proceeded on, and the reduction in the control group was greater. The group effects, time effects and group-by-time effects of body temperature data over time were significant (P＜0.01 for all). The distribution of hypothermia, the time to emerge from anesthesia and incidence rate of postoperative shivering in the 2 groups had significant differences (P＜0.01 for all). There was no statistical difference in bleeding volume during the operation between the 2 groups (P＞0.05). Conclusion The timely temperature-adjustment strategy improves patients′ temperature levels during total knee arthroplasty, and reduces the incidence rate of hypothermia and postoperative shivering, and shortens the time to emerge from anesthesia.