Purpose: This study aimed to shed light on chronic pain prevalence after apparently successful THA and potential predisposing factors. Methodology: A prospective cohort study was conducted on complication-free patients without radiologic signs of loosening or osteolysis to identify the prevalence of chronic moderate to severe pain. As previously identified, moderate to severe pain was defined as a visual analogue scale (VAS) pain score>3. Results and Conclusion: Among 285 hips (253 patients), the mean pain VAS was 1.7 ± 2.2 and 49 hips (17%) experienced moderate to severe chronic pain after THA (VAS>3). Using the painDETECT screening questionnaire, 8% of them reported neuropathic pain, and 82% of them neuropathic pain was unlikely. Shorter follow-up (Pearson's correlation r with VAS pain = -0.14, P=0.02), single marital status, bilateral THA, spinal anesthesia, RA or DDH as indications of THA, duration of the disease (20 vs. 10 months, P=0.001), and more frequent LBP at the follow-up (75% vs. 40%, P<0.001) were significantly associated with painful THA (P<0.05). The study utilized multivariable logistic regression analysis and identified several risk factors, including shorter follow-up duration (OR=1.19), being unmarried (OR=5.26), having rheumatoid arthritis (OR=10.3), longer duration of disease (OR=1.04), severity of pain on the first postoperative day (OR=1.4), and having lower back pain during the follow-up. According to a study, 17% of patients who underwent uncomplicated THA for at least one year experienced moderate to severe chronic pain. The surgeon may benefit from learning about the risk factors leading to chronic pain after THA to improve decisions, risk factor stratification, and post-op pain management.