Seventy-two patients undergoing primary THA were randomized to receive either a commercially available AR navigation system (n=36) or the conventional technique (n=36). The primary outcome of interest was the accuracy of cup positioning, measured by the absolute difference between the desired and achieved angles and the proportion of cups inside the Lewinnek safe zone. Secondary outcomes included operative factors, clinical scores based on the Hip Disability and Osteoarthritis Outcome Score (HOOS), and postoperative complications. Outcomes were assessed within 1 week postoperatively and at 6 months. Overall, the results revealed that the AR navigation group showed improved cup positioning accuracy compared with the conventional technique (median absolute differences of 1° vs. 5° in abduction, and 2° vs. 5° in anteversion; p < 0.001). However, there were no significant differences in operative times, clinical outcomes, or complications between the groups. These findings suggest that while AR navigation improves cup positioning accuracy, it does not translate into significant clinical benefits in the short term.