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Background and Aims The Pericapsular Nerve Group (PENG) block and Anterior Quadratus Lumborum Block (aQLB) are regional anesthesia techniques commonly used for pain control after hip surgery. This study compared their analgesic efficacy during the first 48 hours following surgery under spinal anesthesia.Methods In this prospective, randomized, single-blinded study, patients were assigned to either the PENG group (n = 43) or the aQLB group (n = 30). Pain intensity (resting and dynamic NRS), tramadol consumption, time to first rescue analgesia, and complications were assessed at 2, 12, 24, and 48 hours postoperatively.Results Compared to the aQLB group, the PENG group had significantly lower total tramadol use (p = 0.004) and a longer duration before requiring rescue analgesia (p = 0.048) within 48 hours after surgery.Conclusions The PENG block provides effective postoperative analgesia without causing motor blockade, making it advantageous for early mobilization in patients undergoing hip surgery. It may be a preferable option in multimodal analgesia protocols.