Background:Total knee Replacement (TKR) are rapidly becoming one of the most common elective inpatient surgeries is really cartilage replacement with an artificial surface. The knee itself is not replaced. An artificial substitute for the cartilage is inserted onto the end of each of the bones. At present, cold therapy has been widely used in all kinds of surgery. After TKA, patients are prone to knee swelling and pain, even leading to the loss of knee function in severe cases. Postoperative cold therapy can reduce pain sensation and enhance the effectiveness of early rehabilitation training (Benner, et al., 2019). Aim of this study: is to evaluate effect of performance cold compresses on reducing post-operative pain among patients with total knee replacement. Subjects and method: Design: A quasiexperimental research design was used to achieve the aim of this study. Setting: The study was conducted in orthopedic department at Luxor International Hospital. Sample: A convenience sample of 60 adult patients post-knee replacement surgery. Tools of data collection: First tool Scio demographic and medical data Part (A): assess patients' socio-demographic data Part (B): assess patients' medical data Part(C): patient observational checklist: Part (D): knee range of motion (ROM) checklist; Numerical Rating Scale (NRS) second tool. Result shows a highly statistical significant reduction regarding level of pain between the two groups at 2 nd , 3 rd and 1 week postoperative. The total knee replacement surgery can change the lifestyle of a person living with osteoarthritis or another knee condition that causes continuous pain. The total knee replacement is a more invasive surgery where the bone is cut away and the entire joint is replaced with a prosthesis. Recovery is difficult, and usually takes six to eight weeks of intense physical therapy. The patient still needs physical therapy, but should be able to walk without assistive devices. Recommendations: The total knee replacement is effective at reducing pain in the knee. However, it is useful for different populations. There is more information about the total knee replacement because it is more common, and generally attracts a larger population.