Abstract: [Objective] To analyze the clinical efficacy of direct anterior approach (DAA) in total hip arthroplasty (THA) in patients with femoral neck fracture, and to explore its learning curve. [Method] A retrospective analysis was performed on 58 patients undergoing DAA-THA surgery in our department of Orthopedics from January 2020 to December 2021. The learning curve of DAA-THA operation time was analyzed by cumulative sum (CUSUM) analysis.The perioperative data and imaging data of patients at different learning stages were compared. [Results] All patients were followed up for 12 months.With the accumulation of cases, the surgical time gradually decreased（P＜0.05）, and the learning curve was divided into exploratory phase (case numbers1-22), plateau phase (case numbers 23-32), and maturity phase (case numbers 33-58).There were no significant differences in age, gender, BMI, surgical side and preoperative Harris score at different learning periods (P > 0.05).The length of hospital stay and intraoperative blood loss decreased gradually with the learning curve (P < 0.05).There was no significant difference in Harris scores between the three learning stages before surgery and 6 months after surgery (P > 0.05), and Harris scores in 1 month and 3 months after surgery were continuously improved with the accumulation of cases (P > 0.05).The placement accuracy of acetabular prosthesis also improved gradually in the three learning curve stages.The complication rate of mature stage was significantly lower than that of exploratory stage and plateau stage (P < 0.05). [Conclusion] For patients with femoral neck fracture, DAA-THA has the advantages of less intraoperative damage and faster recovery, but it has a long learning curve, requiring 23-32 cases to reach the technical maturity stage. After the learning curve, DAA can significantly reduce surgical time, length of hospital stay, intraoperative blood loss, and complication rates, and improve implant placement accuracy.