Pharmacological prophylaxis post-total hip arthroplasty (THA) and total knee arthroplasty (TKA) is a common practice aimed at reducing the risk of deep vein thrombosis (DVT) and pulmonary embolisms (PE). However, the impact of early mobilization on DVT risk and the necessity for prolonged prophylaxis remains underexplored. This study investigated the effects of early mobilization and short-duration pharmacological prophylaxis on hospitalizations post-THA and TKA procedures. A total of 3,954 consecutive primary THAs, TKAs, or bilateral simultaneous TKAs were performed, with patients receiving low-molecular-weight heparin as DVT prophylaxis. Clinical DVT, PE, and sudden deaths within 30 and 90 days post-surgery were analyzed. Results showed a decrease in average hospital stay from 8.3 to 4.1 days, with a correlation observed between the duration of prophylaxis and patient outcomes. Clotting episodes were associated with 6 deaths, 22 clinical DVTs, and 12 PEs. Notably, mortality rates were 0% over the last two years with brief DVT prophylaxis. The incidence of DVT varied among procedure types, with THAs showing lower rates compared to TKAs and bilateral simultaneous TKAs. The study suggests a positive correlation between early mobilization, shorter hospital stays, and the risk of clinical DVT and non-fatal PE, underscoring the need for a reevaluation of optimal thromboprophylaxis duration