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Decreased muscle damage is a reported benefit of minimally invasive surgical (MIS) approaches in total hip arthroplasty (THA). We compared the extent and location of muscle damage during THA using the MIS anterior Smith-Peterson and MIS posterior surgical approaches. THA was performed in six human cadavers (12 hips). One hip was assigned to the Smith-Peterson approach and the contralateral hip to the posterior approach. Muscle damage was graded with a technique of visual inspection to calculate a proportion of surface area damage. Less damage occurred in the gluteus minimus muscles and minimus tendon with the Smith-Peterson approach. A mean of 8% of the minimus muscle was damaged via the Smith-Peterson approach, compared to 18% via the posterior approach. The tensor fascia latae muscle was damaged (mean of 31%), as well as direct head of the rectus femoris (mean 12%) during …