In this study, we retrospectively reviewed 70 patients who had a one-stage bilateral total hip replacement in our institution, between 1992 and 1998. Different variables were considered such as gender, age, length of hospital stay, pre-operative diagnosis, duration of the operation and anesthesia, type of prosthesis, complications and amount of blood loss, pre- and postoperative range of motion, incidence of periarticular heterotopic ossifications and postoperative pain and walking distance. In our group of patients one-stage bilateral total hip replacement was found to have resulted in good objective results. Patients with a rheumatoid condition had the highest gain in postoperative hip mobility. In comparison with existing literature there were no more intra- or postoperative complications, making one-stage bilateral total hip replacement a safe procedure in well-selected cases.