Purpose of Review <p>Important aspects of hip replacement surgery to consider are regional anesthesia techniques and postoperative analgesia and ambulation.</p> Recent Findings <p>To maximize targeted pain relief for hip surgery while minimizing postoperative opioid consumption, two ultrasound-guided regional anesthesia nerve blocks are necessary to compare: the lumbar erector spinae plane (L-ESP) block and the pericapsular nerve group (PENG) block. Both the L-ESP and PENG blocks are useful in providing effective regional anesthesia during hip replacement surgery. Additionally, postoperatively, both blocks allow for a decrease in opioid consumption and a preservation of motor function to support ambulation. However, the targets of the blocks are different; the PENG block is focused on the anterior hip capsule, while the L-ESP block has broader coverage and can anesthetize both anterior and posterior hip regions.</p> Summary <p>This narrative review explores the anatomy involved in hip replacement surgery, anesthesia, clinical considerations, and differences in using an L-ESP block compared to a PENG block.</p>