Studies comparing the minimally invasive surgery with 2-incision technique (MIS-2) technique with the conventional transgluteal technique are lacking in the literatures. We compared the clinical outcomes in a series of 166 hips, including 83 MIS-2 total hip arthroplsty (THA) (group I) and another 83 matched-pair series (group II) using conventional transgluteal approach. Demographic data, hospital course, radiographic data, and functional outcome (Western Ontario and McMaster University Osteoarthritis Index and Harris hip score [HHS]) were investigated. The 2 groups significantly differed in 3 and 6-month HHS with a higher HHS in MIS-2 group. But the MIS-2 group had longer operation time, increased blood loss, and more complications. The current study indicates that the benefit of MIS-2 technique was only short-term with quicker functional recovery and shorter duration use of nonsteroid antiinflammatory drugs postoperatively.