The direct anterior approach (DAA) has become a popular approach for total hip arthroplasty (THA) recently because of its atraumatic intermuscular plane, less tissue damage, and faster recovery. Studies comparing DAA with standard lateral or posterior approach showed DAA THAs have better results. These better results of DAA included possible lower dislocation rate, less perioperative pain, shorter length of hospital stay, and better implant position. However, DAA is a technic-demanding approach which needs a longer learning curve, and may endanger lateral femoral cutaneous nerve. DAA may also incurs a higher complication rates in obese patients than other approaches. Similarly, the mini-incision posterior approach (mini-PA) has most of the above-mentioned advantages of DAA except atraumatic intermuscular plane. Comparing with standard posterior approach, the mini-PA resulted in better function scores, shorter length of hospital stay, reduced blood loss, comparable radiographic outcome and complication rates. More recently, the micro-posterior approach (micro-PA), which evolves from mini-PA but preserves short external rotators of the hip except for the piriformis or conjoined tendon and includes all advantages of mini-PA, has been introduced into clinical practice and gained excellent clinical results.