PURPOSE: This study was conducted to investigate the effect of gluteal muscle strengthening exercises (GMSE) with ankle joint pumping exercises (AJPE) on thigh swelling, gait ability, and pain level in patients who underwent total hip arthroplasty. METHODS: A total of 38 patients who had undergone total hip replacement surgery >1 week prior participated in this study. Participants were randomly assigned to a group that performed only GMSE (CG; n = 19) and a group that performed GMSE and AJPE (EG; n = 19). The CG group performed GMSE for 30 min, and the EG group performed GMSE for 30 min followed by AJPE for 15 min. Exercises were performed five times a week, for a total of 20 times over 4 weeks in both groups. Thigh swelling (thigh size), 10 m walking test (10MWT) and timed up and go test (TUG) results, pain level (visual analogue scale, VAS) scores, Short Form 36 health survey (SF-36), and hip outcome scale (HOS) scores were evaluated before and after the intervention. RESULTS: After 4 weeks of intervention, significant differences were observed in the thigh size, 10MWT, TUG, VAS, SF-36, HOS before and after intervention in both groups (p < . 05). However, only thigh size showed a significant interaction between group and measurement time (p < . 05). CONCLUSION: GMSE combined with AJPE might be effective in improving the gait ability and pain level in patients with total hip arthroplasty, and GMSE may be more effective in improving thigh swelling and gait ability than GMSE without AJPE.