Abstract:[Objective] To evaluate the clinical significance of digital virtual planning (DVP) before primary total hip arthroplasty (THA). [Methods] A total of 60 patients who were undergoing primary THA in our hospital from August 2017 to June 2021 were included in this study. According to the doctor- patient communication, 30 patients received the DVP THA, while the remaining 30 patients received conventional THA. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had THA performed successfully with no serious complications. The DVP group proved significantly superior to the conventional group in terms of operative time [(97.3±20.5) min vs (131.2±19.3) min, P＜0.05], intraoperative blood loss [(245.2±20.4) ml vs (322.1±25.6) ml, P＜0.05] and postoperative ambulation [(5.2±4.4) days vs (9.2±3.7) days, P＜0.05]. All of them were followed up for (14.2± 3.6) months on a mean, the DVP group resumed full weight-bearing activities significantly earlier than the conventional group [(10.3±2.2) weeks vs (14.2± 4.2) weeks, P＜0.05]. The Harris score and hip flexion- extension range of motion (ROM) significantly increased (P＜0.05), while the VAS score significantly decreased in both groups over time (P＜0.05). The DVP group proved significantly better than the conventional group at the latest follow-up in terms of Harris score [(93.2±10.9) vs (81.2±8.5), P＜0.05] and hip ROM [(84.5±11.2)° vs (71.6±11.4)°, P＜0.05]. Radio- graphically, the DVP group got significantly more proper postoperative acetabular abduction [(45.6±3.6)° vs (40.1±3.3)°, P＜0.05] and ante- version of the acetabular component [(14.1±2.5)° vs (10.1±2.1)°, P＜0.05], with significantly less deviations of hip center of rotation (HCOR) longitudinally [(2.2±1.7) mm vs (5.2±3.1) mm, P＜0.05] and transversely [(3.3±1.6) mm vs (4.9±3.1) mm, P＜0.05] than the conventional group. In addition, the DVP group gained significantly accurate femoral component in position [medium/displaced, (28/2) vs (21/9), P＜0.05] and size [appropriate/small, (29/1) vs (23/7), P＜0.05] than the conventional group, despite that there was no statistical significance in leglength discrepancy (LLD) between the two groups (P＞0.05). [Conclusion] Preoperative digital image virtual planning does reduce the trau-ma of THA, effectively improve the accuracy of prosthesis matching, and promote the early hip functional recovery.