Outpatient hip and knee arthroplasty is gaining attention as demand for joint replacement grows and hospital resources remain tight, especially during COVID-19. The idea is appealing—same-day discharge, lower costs, and potentially less exposure risk—but the evidence base is surprisingly thin. Only one eligible RCT directly compared outpatient and inpatient total hip arthroplasty (THA), and it found no meaningful differences in pain, function, readmissions, or complications within four weeks. Those early findings suggest outpatient surgery may be comparable, but the certainty is very low and far from conclusive. Observational studies hint at acceptable safety, yet they can’t replace rigorous trials. As interest grows, what’s urgently needed are well-designed non-inferiority RCTs to confirm that same-day discharge truly matches inpatient care in effectiveness and safety.