We report the incidence of total hip replacements performed in Iceland between 1982 and 1996. During this period, 3,403 hip arthroplasties were done. The annual number of procedures increased from 94 hips in 1982 to 323 hips in 1996. Annual rates of total hip replacements due to primary osteoarthrosis per 10(5) inhabitants were 68 in 1982-1986, 90 in 1987-1991, and 114 in 1992-1996. In the years 1992-1996, the age-standardized incidence of total hip replacements for primary osteoarthrosis was 3/10(5) among patients younger than 39 years of age, while it was 621/10(5) among those 70-79 years of age. The mean age at surgery for primary osteoarthrosis was 69 years in both men and women. Incidence rates in various countries are difficult to compare, but by using age-standardized data and correction for differences in population structures between Iceland and Sweden, we find that the incidence of total hip replacement for primary osteoarthrosis of the hip is at least 50% higher in Iceland than in Sweden. This difference is consistent with the higher prevalence of hip osteoarthrosis observed in Iceland than in Sweden.