Among Army aviators, the incidence of total hip arthroplasty (THA) is unknown. This study analyzes the incidence and aeromedical disposition of THA among Army aviators. The U.S. Army Epidemiology Data Register was queried for a 10-year period from calendar year 1987 to 1996. The aviators selected for this study cohort were all qualified and on active flight status before undergoing THA. Data collected included age, gender, diagnoses, and aeromedical dispositions. There were 214,003 aviator-years of observation. Eleven aviators underwent 14 THAs. The overall incidence of THA was 0.05 per 1,000 aviator-years of observation. Of the 11 aviators who underwent THA during the study period, 4 received aeromedical suspension from flying duties (36%). THA is a rare medical event among Army aircrew members. Most are able to return to full flying duties with a waiver. Aircrew members younger than 50 years with THA are more likely to be suspended from aviation duties.