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Introduction Lateral hip pain caused by hip abductor tendon pathology (gluteal tendinopathy or rupture) is increasingly recognized as a distinct clinical entity. Exercise therapy combined with patient education is recommended as first-line treatment. The aim of this study was to investigate changes in lateral hip pain after a 3-month physiotherapist-led education and exercise program in patients with MRI-verified hip abductor tendon pathology.Materials and Methods The intervention comprised seven physiotherapist-led education and exercise sessions, supplemented by daily home-exercises over three months. The primary outcome was the revised Copenhagen Hip and Groin Outcome Score (HAGOS) ‘pain’ subscale; secondary outcome was, hip-abduction strength, and the 30-second chair stand test (30CST). Exploratory subgroup analyses were conducted for MRI-verified tendinopathies versus tendon ruptures. The study was preregistered ( NCT06418217), and the protocol has been published (https://bmjopen.bmj.com/content/15/9/e106517.long).Results 60 female patients with a mean (SD) age of 58.2 (10.9) years were included. Mean (SD) BMI was 29.2 (5.2) kg/m2. A mean improvement of 14.5 [95%CI 9.0;20.0] points in HAGOS ‘pain’ was observed after the intervention. For MRI-verified tendinopathies and ruptures the mean improvements were 11.1 [95%CI 2.9;19.3] points and 18.9 [95%CI 12.0;25.8] points, respectively. No important improvements were seen in muscle strength and 30CST. No adverse events related to the intervention were observed.Conclusion Three months of supervised patient education and exercise led to clinically relevant improvements in lateral hip pain in patients with hip abductor tendon pathology, with large improvements for the rupture group, and in proximity to what has been observed after surgery.