【Abstract】Objective To investigate the accuracy of artificial intelligence (AI) in preoperative prosthesis measurement in total hip arthroplasty (THA). Methods A total of 24 patients with hip deformity admitted from June 2021 to December 2021 were selected and divided into an AI group (12 cases) and a conventional group (12 cases) according to the random number table method to predict the prosthesis size, and the accuracy and feasibility of AI three-dimensional planning were analyzed. Results There were no significant differences in age, gender, BMI, course of disease, operation time, blood loss, hospitalization expenses and postoperative hospital stay between the two groups (P>0.05). The AI group had higher accuracy in prosthesis size prediction than the conventional group, and the difference was statistically significant (P<0.05). There were statistically significant differences in VAS score, range of motion (ROM) and Harris score between the two groups before operation and at the last follow-up (P<0.05). Conclusion AI three dimensions planning has more accurate predictive value than film template measurement in the selection of prosthesis size in total hip arthroplasty.