Background: Osteoarthritis (OA) is a musculoskeletal condition that is affecting an increasing number of individuals due to an aging population. The aim of our case report was to present one-stage bilateral efficient direct anterior total hip replacement via „bikini” incision, to describe the course of the operation, as well as the advantages and the disadvantages of this procedure. Case study: A 38-year old patient, without any comorbidities, presented with severe OA of both hips. Due to co-existing OA on both joints and the patient’s motivation and desire for faster recovery, he underwent a one-stage bilateral hip replacement using a direct anterior approach via a „bikini” incision. Physical therapy began immediately after the surgery and the patient was verticalized on the first postoperative day. Eight days after the procedure, the patient was discharged from the hospital. Conclusion: One-stage total hip replacement should be considered for patients with OA of both hips to reduce the postoperative hospital stay and the need for long-term rehabilitation.