Objective: To study the effectiveness and safety of direct anterior approach in minimally invasive total hip arthroplasty, and to provide the optimal surgical solution for total hip replacement. Methods: from February 2014 to January 2016 in our hospital department of orthopedics diagnosis in treatment of 80 patients undergoing total hip replacement patients were randomly divided into observation group (40 cases) and control group (40 cases), all patients were given basic treatment of limb fixation uniform before operation. The observation group was treated by direct anterior approach, and the control group was treated with posterior lateral approach.The two groups of patients with surgical incision length, intraoperative blood loss, blood transfusion and other general conditions, after 6 weeks, 3 months and 6 months Harris hip joint function score were compared by t test, and the postoperative complications of evaluation and analysis using SPSS 21 software for variance statistics comprehensive evaluation, effect and feasibility of direct anterior approach of minimally invasive total hip replacement. Results: the observation group patients in the intraoperative incision length, operative time, intraoperative bleeding and transfusion, and the control group with significant difference (P<0.05); there was significant difference in Harris scores at 6 weeks hip joint function after operation in the two groups after operation (P<0.05); 3 months and 6 months Harris hip score and there is no significant difference (P>0.05); two groups of patients with postoperative complications had significant difference (χ²=4.50 P<0.05). Conclusion: minimally invasive total hip arthroplasty in patients with postoperative posterolateral approach group, which is conducive to the early recovery of patients, 6 weeks after the observation of curative effect and posterolateral approach group, it is worth in clinical application.