Background: Avascular necrosis of femoral head (AVN) and post–traumatic sequelae are very common indications for total hip replacement (THR). While AVN involves the femoral head, sparing the acetabulum, post traumatic sequelae includes pathology in the acetabulum. Research question: Whether or not the integrity of acetabulum is a factor in the final outcome of the hip replacement surgery? Materials and methods: The present study includes 50 AVN hips and 32 post acetabulum fractures who underwent THR in our institute. They were assessed for functional outcome using standard Harris hip score (HHS) and their quality of life was assessed using short musculoskeletal functional assessment (SMFA) and SF–36 scores. Results: The mean HHS in AVN hips was 87.04 and in acetabulum fractures, it was 84.25 with no statistically significant difference between the two (p=0.9). Both the quality of life scores did not yield any statistically significant difference between the two groups either (p>.05 ). Conclusion: Acetabular pathology does not play a significant role in the final outcome after total hip replacement.