The purpose of this study was to compare functional outcome and survival of isolated acetabular, isolated femoral and both component revision after failure of primary Birmingham Hip Resurfacing. The Oswestry Outcome Centre prospectively collected data on 5000 hip resurfacing between 1997 and 2002. Of these, 182 hips were revised: 8% had revision of the acetabular component only, 42% had revision of the femoral component only to conventional stemmed prosthesis, and 50% had revision of both components to conventional total hip arthroplasty (THA). We used a postal questionnaire to assess function by Harris and Merle d'Aubigné and Postel hip scores and determined survival using re-revision as an endpoint. In patients with isolated acetabular revision, the median Harris hip score (HHS) was 74 at a mean of 4.5 years follow up. Isolated femoral revision had a median HHS of 82 at a mean of 3.8 years. When both components were revised, the median HHS was 85 at a mean of 4 years. We observed no difference in HHS between the groups. There was an average survival of 92% at 10 years. Survival was significantly lower for isolated acetabular revision (75%) than isolated femoral (93%) or both component revision (96%).