Background: Hip arthroplasty is frequently associated with significant postoperative pain, which can delay mobilization and recovery. Effective pain management is necessary for early recovery, improved functional outcomes & reduced complications in proximal femur fracture surgeries. Regional anaesthesia techniques, such as the Pericapsular Nerve Group (PENG) block and QuadratusLumborum Block (QLB), have gained prominence for their ability to provide targeted analgesia while minimizing opioid use. The PENG block selectively concentrates on the articular branches of lumbar plexus, preserving quadriceps strength and enabling early mobilization, whereas the QLB offers broader analgesia with variable motor involvement. Despite their growing use, comparative data on these techniques in proximal femur fracture surgeries are limited.This research sought to assess and compare the effectiveness of analgesia, opioid-sparing effect, quadriceps strength preservation & safety of the PENG and QLB techniques to optimize postoperative pain management strategies. Materials and Methods: This trial, which was prospective, randomized, double-blind, and controlled, involved 84 patients divided in three groups PENG group (n=28), QLB group (n=28) and control group (n=28) who were scheduled for surgery to treat proximal femur fractures.The primary objective aimed to compare pain ratings based on the Visual Analogue Scale (VAS) across the three groups at various time points: 30 minutes post-procedure, during spinal positioning, upon admission to the PACU, at discharge from PACU, and at 12, 24, and 48 hours post-surgery. Secondary objective was to compare the total consumption of opioids, time of first rescue analgesia, quadriceps strength, time of first standing, satisfactory score at time of discharge and incidence of block complications. Results: At 12 hours in the early postoperative phase, the PENG block group's VAS scores (2.61 ± 0.629) and QLB group's (3.36 ± 0.870) scores were considerably lower than those of the control group (3.79 ± 0.876), with a p-value of 0.0001. In comparison to the QLB group, the PENG group had lower VAS values. Regarding opioid consumption, the PENG group used significantly less tramadol (7.14 ± 17.817 mg), with over 90% of patients not needing rescue analgesia. In contrast, the QLB group required 41.07 ± 45.243 mg, with nearly 50% of patients needing additional analgesia (p < 0.05). The control group received 200 mg of tramadol during the first twenty-four hours, administered in divided doses as a part of conventional analgesia. The PENG group showed the highest preservation of quadriceps strength, with 82.1% (23/28) of patients maintaining intact strength at 24 hours. In comparison, 60.7% (17/28) patients in QLB group and 50% (14/28) in control group retained quadriceps strength, highlighting the PENG block's superior muscle strength preservation. Conclusion: The study concluded that the PENG block outperforms the QLB and control approaches in proximal femur fracture surgeries like hip arthroplasty, offering better pain relief, lower opioid use, and longer time to first rescue analgesia, while preserving quadriceps strength for early mobilization and faster recovery. The QLB also provided effective analgesia but with less consistent muscle strength preservation. Both blocks were safe, with no significant adverse events. The PENG block is recommended as the optimal choice for postoperative management of pain in hip arthroplasty.