Purpose <p>Hip osteoarthritis is a common chronic condition primarily affecting the elderly, characterised by the presence of pain, joint stiffness, and restricted movement. Ultrasound-guided Pericapsular Nerve Group (PENG) block combined with viscosupplementation may offer symptomatic improvement in patients with hip osteoarthritis unable to undergo total hip arthroplasty. The aim of this study was to evaluate pain and function in patients with hip osteoarthritis following the administration PENG block combined with viscosupplementation.</p> Methods <p>A retrospective study of 17 consecutive patients (12 Female; 5 Male) with hip osteoarthritis who underwent ultrasound-guided PENG block combined with viscosupplementation were included in the study. The primary outcome was pain assessed using the Visual Analogue Scale (VAS), and function measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and 12 weeks after the procedure. The secondary outcome was complication rate.</p> Results <p>The mean and standard deviation age was 76.5 ± 8.3 years (range 63–93). There was a significant reduction in mean VAS of 3.6 points (<i>p</i> &lt; 0.001) and a reduction in WOMAC score of 29.1 points (<i>p</i> &lt; 0.001). The majority of participants reported being satisfied with the procedure (82.4%). The minor complication rate was 11.8% (ongoing pain requiring analgesia and transient hip flexor weakness). No major complications were observed during the follow-up period.</p> Conclusions <p>The ultrasound-guided PENG block combined with viscosupplementation demonstrated improvement in pain and function without major complications after 12 weeks of follow-up in patients with hip osteoarthritis.</p> Level of evidence <p>Level IV, case series.</p>