From 1969 until 1985, 39 total hip arthroplasties (THAs) were performed in 38 patients for hemophilic arthropathy. The median age of patients at operation was 48.1 years. Twenty-two of these hip replacements in 21 patients were reviewed clinically and roentgenographically with a median follow-up study of 7.6 years. Five of the 22 hips have been revised and three are likely to require revision in the near future. The incidence of revision is compared to other studies of THA in young patients and the influence of human immunodeficiency virus infection is examined. Total hip arthroplasty in the hemophiliac is believed to be an appropriate operation for disabling hemophilic arthropathy.