This systematic review and meta-analysis evaluated the efficacy of the Pericapsular Nerve Group (PENG) block versus Periarticular Infiltration (PAI) in managing postoperative pain after Total Hip Arthroplasty (THA). Through an exhaustive search of PubMed, EMBASE, and Cochrane databases, three randomized controlled trials (RCTs) involving 152 patients were analyzed using Rstudio 4.2.3, with heterogeneity and bias risk assessed via Cochran Q test, I2 statistics, and the RoB-2 tool. Results showed that PENG block provided significantly lower pain scores at rest at 6 hours postoperatively. However, no significant differences were observed at 12 and 24 hours, indicating the transient superiority of PAI is not maintained beyond the early postoperative period.