Background: Ultrasound (US)-guided injection is increasingly used for magnetic resonance (MR) arthrography of the hip. There is no information regarding the utility of anesthetizing the needle path before joint puncture. Thus, the aim of this study was to retrospectively compare the efficacy of the technique and discomfort in patients undergoing US-guided arthrography of the hip using a fixed guide, with or without the use of subcutaneous local anesthesia. Materials And Methods: Eighty-two patients underwent anterior US-guided MR arthrography of the hip, of whom 33 had received anesthesia and 49 had not; these patients were compared for differences in the efficacy of arthrography and the subsequent complications. They were also asked to report the intensity of discomfort using a visual analog scale (VAS). Results: Hip joint arthrography was successful in all cases with no complications. There were no significant differences between the anesthetized and non-anesthetized groups in terms of sex, age, body mass index, side, success rate on first attempt, and extra-articular contrast leakage on MR (P > 0.05). The mean VAS scores were 23.3 (median 25.0; SD 13.3) in anesthetized patients versus 23.6 (median 20.0; SD 19.2) in those who were not anesthetized (P = 0.12，Mann-Whitney Utest). Conclusion: Routine local anesthesia is possibly unnecessary in US-guided MR arthrography of the hip using a fixed guide.