Objective To explore the effect of preserved infrapatellar fat（IPFP）pad on the postoperative function and wound healing of patients undergoing artificial total knee arthroplasty. Methods A total of 150 patients with severe knee arthritis were randomly divided into IPFP resection group and IPFP preservation group. The follow up time was 1 month，2 months，3 months，6 months and 12 months after operation. There was no significant difference in gender，age，anterior knee pain，KSS knee function score and range of motion between the two groups before operation. Results All the 150 patients were included in the study. There was no difference between the two groups in the operation time，postoperative drainage volume and postoperative drainage time（P > 0.05）. The follow.up results showed that there was no difference in the KSS knee function score between the two groups at each time point after operation. However，the incidence of subincisional exudation in the IPFP resection group was significantly higher than that in the IPFP preservation group（13% vs. 6%，P < 0.05）. At 1，2 and 3 months after operation，the anterior knee pain level of the resection group was significantly higher than that of the preservation group（P < 0.05），but at the other two time points，there was no significant difference between the two groups. Conclusion The preservation of infrapatellar fat pad during total knee arthroplasty can increase the incidence of early postoperative wound exudation and early postoperative anterior knee pain. The infrapatellar fat pad should be preserved as much as possible or even reconstructed during the operation.