Background: Total Hip Replacement (THR) is one of the most common orthopedic procedures that are used to treat various hip disorders that cause pain and limitation of movements. It is usually carried out on patients with osteoarthritis, rheumatoid arthritis and traumatic arthritis and avascular necrosis. Objectives: The aim of this study is to identify the impact of Total Hip Replacement in 100 patients of MMC Mardan from January 2020 to July 2023 and the issues occurred during this procedure. Study Design: A retrospective cohort study Place and duration of study: This retrospective cohort study was conducted on 100 patients at Department of Orthopedic MMC Hospital Mardan from January 2020 to July 2023. Materials & Methods: A retrospective cohort study was employed on 100 patients who had received THR. The data was retrieved from the patients’ records which included; patients’ electronic files with details of their age, gender, preoperative diagnosis, details of surgery and the postoperative findings. The HHS was employed to assess the functional status of the patients at six months post the surgery. Results: The participants were 55 males and 45 females with age between 45 and 80 years. The indications for surgery were OA 60%, RA 15%, traumatic arthritis 10% and AVN 15%. The postoperative complications noted in the study were infection which was reported in 2% of the patients, dislocation which was reported in 3% of the patients, DVT in 1% of the patients and periprosthetic fracture in 1% of the patients. Among all the HHS results obtained in this study, 60% of them were categorized under the excellent group while 25% under the good group, 10% under the fair group and 5% under the poor group. Majority of the patients were content with the treatment, 90 percent of them testified to improved health status. Conclusion: Total Hip Replacement is effective in the management of pain and improvement of functional status of patients with severe hip diseases with relatively low risk of complications. Concerning the results of the procedure, patients’ overall QoL improved, which can be considered evidence of the procedure’s efficacy.