Same day total joint arthroplasty (TJA) is a hot topic as the volume of TJA rises globally and healthcare resources become more and more limited. Furthermore, advancements in surgical technique have made rapid recovery more realistic. Thus, there has been a push towards outpatient TJA in recent years. An important consideration in the feasibility of outpatient TJA is choosing the appropriate setting for it. Thus, in this study, the authors randomized same day TJA patients to stay at an ambulatory outpatient surgical centre or at a standard hospital arthroplasty ward . Randomizing 50 patients, the authors found no significant differences between the two groups in terms of successful same-day discharge, although there was a trend towards greater success in the group staying at the outpatient surgery centre. Specifically, while all THA patients were discharged home successfully regardless of location, TKA patients were significantly more likely to be discharged home if they were at the ambulatory surgical centre compared to the inpatient ward. Overall, it appears that an ambulatory surgical centre is not only safe for same day surgery, but may in fact improve its likelihood of success.