Overall, however, the nature of the relationship between mental health and young adult hip pathology, particularly in the post-operative period, remains unclear. The aim of this study was to evaluate the change in the presence of mental health symptoms from pre- to post-operative, following hip preservation surgery, using the UK Non-Arthroplasty Hip Registry. Specifically, the objectives were to: 1) determine if there is a significant change in mental health scores collected through the NAHR from baseline to post-operative for patients undergoing hip preservation surgery, 2) to determine if these changes are similar between patients undergoing PAO and hip arthroscopy, and 3) evaluate the trajectory of change in mental health scores post-operatively. This registry study was conducted using data from the UK's NAHR, and is reported according to the STROBE Statement and checklist. Patient demographics, such as age, sex, body mass index (BMI) were collected. The details of the surgical procedure(s) performed were also obtained, along with the two routinely collected PROMs iHOT12 and EQ5D. The iHOT-12 includes a ‘social, emotional, and lifestyle’ domain (Questions 8, 9, 10, 12), and the EQ-5D dedicates one of its five dimensions to anxiety/depression, with a five-point Likert scale. Both scales been extensively validated, including in this particular patient population and pathology. The mean score on the iHOT-12 Social, Emotional, and Lifestyle (SEL) Concerns domain at baseline among patients undergoing hip arthroscopy was 32.2 (21.0), which increased significantly to 56.9 (29.7) at 6 months (p < 0.001), and remained stable at 1 year at 59.6 (30.5, p = 0.05). Among patients undergoing PAO, the mean score at baseline on the SEL domain was 32.7 (20.0), which improved significantly to 53.8 (29.8) at 6 months (p < 0.001), and remained stable at 1 year at 56.4 (30.6, p = 0.25). Patients undergoing hip preservation surgery demonstrate a significant improvement of 65–77% in self-reported mental health symptom scores at 6 months, and this is maintained at least up to 1 year post-operatively.