Background: Total Hip Arthroplasty (THA) is crucial for treating hip trauma, with anterior and posterior approaches being commonly employed surgical techniques. Objective: This study compares the efficacy of anterior versus posterior approaches in THA for trauma patients in Bangladesh, focusing on recovery, complication rates, and overall patient satisfaction. Method: A prospective study was conducted from May 2023 to July 2024 at Christian Mission Hospital, Rajshahi. Thirty-five trauma patients were randomly assigned to either the anterior (n=17) or posterior (n=18) approach. Data collection included postoperative recovery times, complication rates, and patient-reported outcomes using standardized assessments. Results: Patients in the anterior group had a 20% faster recovery time, with 70% (n=12) achieving full mobility within eight weeks, compared to 55% (n=10) in the posterior group. The complication rate was 17.6% (n=3) for the anterior approach and 22.2% (n=4) for the posterior approach. The average hospital stay for the anterior group was 5.2 days, compared to 6.4 days for the posterior group, representing a 19% reduction in hospitalization duration. Patient satisfaction was slightly higher in the anterior group, with an average satisfaction score of 85%, while the posterior group averaged 80%. After six months, 94% (n=16) of patients in the anterior group and 89% (n=16) in the posterior group reported successful functional outcomes. Conclusions: The anterior approach demonstrated faster recovery and shorter hospital stays, though both approaches Aresulted in similar long-term outcomes and patient satisfaction.