Total hip replacement is widely in use all over the world. It is an extremely beneficial procedure. But some requirements must be fulfilled: an excellent indication, a good technique and a special choice of the material in use. For elderly patients less demanding, regular metal on polyethylene cemented implants are still in use. For younger patients, more sophisticated materials like ceramic on ceramic, or metal on metal seem to be more appropriate. The way the prosthesis is stabilized, using or not cement, is also of marked importance. Many other details are relevant: the approach, the surgical technique, the way the patients are followed, the survivorship analysis which can predict partially the outcome in the future for a given prosthesis.