Objective:To explore the effects of an improved perioperative diet management based on the concept of enhanced recovery after surgery (ERAS) in patients undergoing total hip arthroplasty (THA) .Methods:From May 2020 to May 2022, convenience sampling was used to select 320 patients who underwent their first unilateral THA at the First Affiliated Hospital of Zhengzhou University. According to the random number table method, patients were divided into control group ( n=160) and observation group ( n=160). The control group adopted a routine perioperative diet management, while the observation group improved the perioperative diet management based on the ERAS concept, and nurses performed preoperative fasting and postoperative diet and drinking water nursing according to the plan. We compared the preoperative hunger and thirst between two groups of patients, and recorded the gastrointestinal function such as postoperative anal exhaust and defecation time, bowel sound recovery time, postoperative nausea and vomiting degree, and post eating nausea and vomiting degree between the two groups. Results:The number of preoperative hunger and thirst patients in the observation group was less than that in the control group, and the postoperative exhaust time, defecation time, and bowel sound recovery time were shorter than those in the control group ( P<0.05). The degree of nausea and vomiting after eating after surgery was lower than that in the control group. The differences were all statistically significant ( P<0.05) . Conclusions:The improved perioperative diet management based on ERAS has good clinical effects in THA patients, reducing perioperative discomfort and promoting postoperative gastrointestinal function recovery.