Introduction: Total hip replacement (THR) is a well-established surgical intervention for advanced osteoarthritis aimed at alleviating pain and restoring joint function. Evaluating short-term functional outcomes is critical to understanding the immediate benefits of the procedure and identifying factors influencing recovery. Improvements in mobility, pain relief, and quality of life are key indicators of success. This study aimed to assess the short-term functional outcomes of Total hip replacement (THR) in osteoarthritis patients. Methods & Materials: This prospective observational study was conducted at the Department of Orthopedics, Dhaka National Medical College, Dhaka, Bangladesh, from January 2014 to December 2024. A total of 30 patients of osteoarthritis managed by Primary total hip replacement were enrolled purposively. Outcomes were assessed clinically and functionally using the Modified Harris Hip Score. Data were analyzed using MS Office tools. Results: Avascular necrosis was the most common indication for hip replacement, accounting for 68.3% of cases. Postoperative complications included superficial infections (6.7%), limb length discrepancy (5.0%), foot drop (3.3%), and dislocation (1.7%). The mean Modified Harris Hip Score improved significantly from 31.4 ± 5.3 preoperatively to 87.6 ± 7.6 postoperatively (p < 0.001). Grading of the score showed that 63.3% of cases achieved excellent results, with 21.7% good, 11.7% fair, and 3.3% poor outcomes. Conclusion: The short-term functional outcomes of total hip replacement in osteoarthritis patients demonstrate significant improvement in both clinical and functional aspects. With minimal complications and a high percentage of excellent and good results, this procedure proves effective in enhancing patients' quality of life.