Introduction: Osteoarthritis (OA) is a prevalent degenerative joint disease, especially in the elderly, posing a significant public health concern. Hip osteoarthritis affects millions of individuals worldwide and significantly impairs their quality of life. Surgical interventions for hip osteoarthritis aim to alleviate pain and restore function. Surgeons face a choice of surgical approaches, including anterior, posterior, and lateral approaches, each with its advantages and risks. This narrative review explores the consequences of these approaches on patients' functional and motor capacities, with a hypothesis that the anterior approach may offer superior functional recovery due to better muscle and tissue preservation. Methods: The review was conducted by searching PubMed and ScienceDirect for articles published between 2010 and 2023, written in English, and related to primary hip arthroplasty. The search focused on keywords related to hip arthroplasty, gait, locomotion, functional recovery, and surgical approach. A total of 98 potentially relevant articles were identified, and 72 met the inclusion criteria. Various questionnaires were used to assess the outcomes, such as HOOS, OHS, and SF-36. Results and Discussion: The review included 30 articles comparing the effects of anterior vs. posterior approach, 11 comparing anterior vs. lateral approach, and 1 comparing lateral vs. posterior approach. Eight articles studied all three approaches. The posterior approach offers better visibility of the hip joint but may result in more post-operative pain and a higher risk of hip dislocation due to muscle weakness. The lateral approach provides direct visibility of the hip joint and faster recovery but can also lead to postoperative pain and abductor weakness. The anterior approach, while requiring more surgical expertise, offers advantages such as reduced hospital stay, decreased pain, lower risk of dislocation, and faster recovery, including improved gait and hip flexion. Some articles noted a significant temporal effect for maximum hip extension and stride length, with the anterior approach showing better results in the short term. However, differences tend to disappear beyond three months post-surgery, especially with the lateral approach. Conclusions: Most studies suggest that the direct anterior approach may result in greater early postoperative improvements compared to lateral and posterior approaches. The choice of approach should depend on the surgeon's experience and the patient's specific needs. All three approaches have their pros and cons, but they yield similar results one year after surgery. Patients should engage in discussions with their surgeons and ask relevant questions to make informed decisions. Future research should focus on assessing rehabilitation efficiency based on the surgical approach chosen.