BACKGROUND: Total Hip Arthroplasty (THA) is a transformative surgical intervention for hip joint disorders, necessitating meticulous preoperative planning for optimal outcomes. With the emergence of Artificial Intelligence (AI), preoperative planning paradigms have evolved, leveraging AI algorithms for enhanced decision support and imaging analysis. This systematic review aims to comprehensively evaluate the role of AI in THA preoperative planning, synthesizing evidence from studies exploring various AI techniques and their applications. METHODS: A systematic search of PubMed, Scopus, and Web of Science databases was conducted to identify relevant articles. Inclusion criteria encompassed studies focusing on AI in THA preoperative planning, including randomized controlled trials (RCTs), observational studies, and comparative studies. RESULTS: Six studies from China met the inclusion criteria, collectively analyzing 831 patients. AI-assisted planning demonstrated superior accuracy in estimating prosthesis size and positioning compared to traditional methods. However, limitations such as geographic bias and language constraints were noted. CONCLUSION: AI-assisted preoperative planning significantly enhances femoral positioning accuracy, providing superior outcomes compared to traditional methods. This improvement in precision, particularly in the placement of femoral and acetabular components, has been consistently observed across studies, making AI an indispensable tool in improving the overall success of Total Hip Arthroplasty. Despite promising findings, further research is warranted to address limitations and optimize the integration of AI technologies into routine clinical practice.