Total hip replacement (THR) is a commonly performed orthopedic procedure with an increasing rate of utilization. It is performed to relieve symptoms of pain and help restore the loss of function that follows advanced hip diseases, including osteoarthritis, rheumatoid arthritis, and avascular necrosis. Although there are numerous studies evaluating patient outcomes after THR with respect to physical functioning and pain relief, relatively few studies have specifically evaluated changes in health-related quality of life (QOL). We reviewed a total of 20 studies that evaluated changes in QOL after THR. Results of all studies were consistent in showing beneficial and often dramatic improvements in QOL after elective THR. These improvements were most likely to occur within the first 3 to 6 months after THR. Future research should assess the impact of both patient-level predictors and the role of various surgical approaches in contributing to successful outcomes after THR.