The improvement of surgical and anesthesia techniques has markedly extended the range of patients undergoing hip replacement both in terms of age and comorbidity. Hence, the risk of perioperative complications has increased ranging from hemorrhages, postoperative delirium, incomplete pain control, hypotension, and others. In this regard, a personalized approach from the preoperative evaluation to the choice of the type of anesthesia and the pain control strategy is preferred in order to minimize the risk of complications and accelerate patient’s recovering time. In this chapter, we aim to describe different options and propose different possible approaches for the possible scenarios in the light of the existing evidence in the field.