Acute postoperative problems associated with total hip arthroplasty typically require prompt attention. Because the circumstances surrounding these problems provide limited time for consultation or literature review, effective management depends on the surgeon being aware of treatment options and favored treatment methods and executing the best treatments. Surgeons should be aware of management strategies for the most common and difficult early postoperative complications after primary total hip arthroplasty, including wound problems, periprosthetic femur fractures, nerve dysfunction, and venous thromboembolism. State-of-the-art knowledge will help the treating surgeon successfully manage complications.