Objective: This study investigates the efficacy of biomechanical footwear in improving gait parameters, reducing pain, and enhancing functional mobility in patients with hip osteoarthritis, compared to standard footwear and no intervention. Methods: A randomized controlled trial was conducted with 120 participants diagnosed with hip osteoarthritis. Participants were randomly assigned to one of three groups: biomechanical footwear, standard footwear, or control. Outcome measures included gait parameters (stride length, gait speed, cadence), pain levels (Visual Analog Scale), functional mobility (Lower Extremity Functional Scale), and quality of life (Short Form Health Survey). Assessments were performed at baseline, post-intervention (8 weeks), and at a 4-week follow-up. Results: The biomechanical footwear group demonstrated significant improvements in stride length, gait speed, cadence, and pain reduction compared to the standard footwear and control groups. Functional mobility and quality of life also improved significantly in the biomechanical footwear group. The standard footwear group showed some improvement, but less pronounced than the biomechanical footwear group. The control group exhibited no significant changes. Conclusion: Biomechanical footwear significantly enhances gait parameters, reduces pain, and improves functional mobility and quality of life in patients with hip osteoarthritis. These findings suggest that biomechanical footwear is a beneficial intervention for managing hip osteoarthritis.