Background: The majority of people with hip arthritis get significant pain alleviation after undergoing total hip replacement. Objective: Evaluation of both early clinical as well as radiological outcomes of cementless total hip arthroplasty in young adults. Subjects and Methods: This was an interventional clinical trial that included 18 patients who were recruited from Orthopedic Department and had osteoarthritic hip who were treated with total hip arthroplasty (THA). Harris hip score (HHS) was utilized for clinical evaluation at 6 weeks, 3 months, and 6 months after surgery, and radiographs were evaluated for loosening signals at the end of 3 months and 6 months. Results: All HHS items improved significantly from 28.3 ± 15.9 to become 85.9 ± 6.7 with a p-value < 0.001 and the percent of improvement (70.4%) ranged from 43.1% to 89.2%. Postoperative HHS was significantly higher in patients without complications compared to those with complications, among males when compared to females, in cases under the age of 60 compared to those over the age of 60, and in cases with osteoarthritis compared to those who had avascular necrosis. Conclusion: Cementless total hip arthroplasty (THA), offers promising outcomes where it led to pain reduction, functional recovery, and enhanced quality of life.