Total knee arthroplasty (TKA) is considered a cost-effective and efficacious treatment for patients with end-stage knee arthritis. Meanwhile, TKA has been regarded as one of the most painful orthopaedic surgeries. Pain control after TKA remains a challenging task. Many analgesic innovations are used to reduce the level of pain, but none has been proven to be the optimum choice till now. Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. This approach is a preferable choice in relieving postoperative pain with minimum side effects. This paper aims to review pre-emptive analgesia for pain management in TKA. We reviewed the application of pre-emptive analgesia, its physiological mechanism, and the techniques.