What is the role of imaging in before, during, and after total hip arthroplasty (THA)? Radiographs are the first level of imaging in the preand postoperative study of THA. Imaging is fundamental to identifying the correct indications for THA. It is also important in judging the morphology of the femur in terms of flare and the cortical index and of anteversion. These features are the main factors in the choice of femoral stem geometry. In the postoperative phase, imaging is fundamental for the serial evaluation of fixation. In my experience, some concerns exist about the use of imaging during surgery. I only use it in difficult cases during surgery, especially in revision surgery where the bone loss could influence improper stem position. In primary cases, its use should be limited; for example, I consider its use in the first phase of learning to perform a new approach and using a new implant.