Total hip arthroplasty (THA) is an effective treatment for elderly femoral neck fractures, mid- to late-stage femoral head necrosis, and end-stage hip osteoarthritis. However, serious complications such as aseptic loosening of the prosthesis, peripheral fractures, and dislocation of the prosthesis still exist following THA, which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons. Currently, the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional (2D) X-ray or three-dimensional (3D) computed tomography (CT), which fail to adequately consider the hip joint in weight-bearing as well as motion, lumbar-hip joint changes, and prosthetic impingement during motion. Recently, the dual fluoroscopic imaging system, as a new in-vivo, dynamic radiological imaging technology, provides comprehensive and accurate dynamic 3D data for THA preoperative planning. However, the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established, which affects the promotion and application of this technology. In light of the above, national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues, and the ‘expert recommendation rate’ and ‘strong recommendation rate’ were obtained through a questionnaire survey on the recommendations of the participating experts. This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.