Background It is well accepted that the minimally invasive surgery (MIS) for total hip arthroplasty (THA) should combine with less or no muscle damage and is different from mini-incision technique and MIS should have better outcomes than mini-incision surgery.The aim of current analysis was to apply an explicitly defined sub-group analysis to confirm whether this hypothesis is true.Methods A computerized literature search was applied to find any data concerning MIS or mini-incision THAs.A multistage screening was then performed to identify randomized studies fulfilling the inclusive criteria for the analysis.The data were extracted,and sub-group analyses of MIS or mini-incision surgery for different kinds of outcomes were carried out.The P(sub) value for difference between MIS sub-group and mini-incision sub-group was also calculated.Results Eleven studies that fulfilling the inclusion criteria were included,with 472 cases in the study group (MIS or mini-incision) and 492 cases in the conventional group.The overall analysis showed the study group would achieve less surgical duration (P=0.037),intraoperative blood (P ＜0.001) and incision length (P ＜0.001) than conventional group.The difference between sub-groups showed,the MIS would achieve shorter incision length (P(sub) ＜0.05) and bigger cup abduction angle (P(sub) ＜0.05),and cause more blood loss (P (sub) ＜0.05) than mini-incision technique.Other indexeswere comparable between the two sub-groups.Conclusions Though further high quality studies are still needed,the result of current analysis offered an initial conclusion that MIS THA failed to achieve a better clinical outcome than mini-incision technique.The exact definition of MIS still needs to be improved.