164 patients scheduled for total hip arthroplasty were randomized to surgery through either the direct anterior approach or direct lateral approach. Patients were assessed over 2-year follow-up for outcome related to the Harris Hip Score, the 6-minute walk test, the Oxford Hip Score, and the EuroQol 5-dimensions questionnaire (EQ-5D). Results for all aforementioned measures demonstrated no significant differences between the direct anterior approach group and the direct lateral approach group at 2 years. The only significant difference noted was in the rate of patients with a positive Trendelenburg test, which was significantly lower in the direct anterior approach group at 3 months and 2 years.