131 patients, presenting with hip osteoarthritis, were randomized to either 8 weeks of exercise therapy (ET), exercise and manual therapy (ET+MT), or 9 week wait-list, as a control before randomization to the same two groups. At the end of 18 week period, comparing both treatments as well as the effect of initiation time, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function (PF), hip range of motion, and patient perceived change was the same between the two therapy groups. Patient satisfaction was, however, higher in a group that underwent exercise and manual therapy. Immediate commencement of therapy resulted in better WOMAC physical function, ROM and patient global assessment scores than a 9 week wait period.