In the recent past, total hip replacement (THR) surgery in naval aviation personnel has been considered for selected individuals. There is a trend in the armed services to return individuals to flight status after total hip arthroplasty. Some individuals have successfully returned to ejection seat aircraft. A case report of an aviator who returned to tactical flying in the F/A-18 community is presented. This naval aviator has functioned successfully on a shipboard environment and accumulated in excess of 900 flight hours without functional compromise after successful hip arthroplasty, reporting no difficulty with aviation-related ergonomic issues, such as ingress/egress, sitting in a confined cockpit, or tolerating G forces. Two other individuals have also returned to flight status, but have not accumulated a significant number of flight hours to warrant evaluation. Irrespective of the apparent early success in returning to flight status, significant concerns remain. This preliminary assessment of individuals returned to flight status after THR appears to justify return to flight status, including ejection seat aircraft. However, there is a potential for hip fracture or dislocation in the event of ejection or PLF which poses significant risks for aircrews requesting return to flight status after THR. Additionally, personnel in this relatively young population should be advised of the likelihood of accelerated wear imposed by strenuous activity.