A diagnosis of periprosthetic joint infection after total hip arthroplasty remains a challenge without a simple solution. It can be difficult to distinguish from aseptic failure of a total hip but is a significantly worse complication. Recent research has gone into attempting to find a cost-effective laboratory test or imaging modality that can assist in definitive diagnosis of periprosthetic joint infection, but there is no single most effective test as of yet. There are several promising possibilities arising from a variety of serum and synovial laboratory values, including alpha-defensin and leukocyte esterase tests. This review provides information on the most recent advances in the literature with regards to diagnosis of periprosthetic joint infection after total hip arthroplasty.