Background: Pain can range from moderate to severe after total hip arthroplasty, a routine surgical procedure. The functional recovery and long-term functional result of a surgical patient depend on early ambulation and physical therapy. Hence, the primary goal of postoperative pain management following THA continues to be providing for maximal pain relief while safeguarding motor function. Patients and Methods: Sixty adult cases were part of this prospective randomised double-blind controlled trial at Tanta University Hospitals from August 2021 to June 2022. Patients were randomly allocated according to technique used into two groups. Group I (control group): Received sham PENG block (just 1 mL saline). Group II (PENG group):Received real PENG block (20 mL of bupivacaine 0.25% +0.2 mg/mL dexamethasone). Results: In the PENG group, pain scoring was significantly lowered, considerably longer intervals among first pain and the need for analgesia, the total dosage of morphine used up in the first twentyfour hrs was significantly decreased, patients were very satisfied, there was no motor blockage nor quadriceps muscle affection compared with control group. Inconsequential differences existed between both group in time to first sit and time to do active exercise but there was a drastic drop in time to stand and walk in PENG group in contrast to the placebo group, Following the operation, cases in the PENG group experienced a substantially reduced rate of nausea and vomiting compared to control group. But As far as bradycardia, hypotension, and respiratory depression go, there were no discernible changes among the two groups. Conclusion:The preoperative ultrasound guided PENG block is an efficient tool for postoperative analgesia in cases undergoing total hip arthroplasty without significant effect on motor block or the incidence of complications.