The optimal approach for total hip arthroplasty is hotly debated. We analysed 121 consecutive patients who underwent primary total hip arthroplasty during the first three years of practice of a newly appointed consultant. Patients were analysed for pain scores (1-6), function scores (1-6) and satisfaction levels (1-5). All complications, during and after surgery, were noted with special emphasis on incidence of dislocation and factors contributing to it. The results were gratifying and were comparable with major series of total hip replacement via the posterior approach. No patient had a dislocation. One hundred and five patients (89%) had no or minimal pain after the surgery. Eighty-six patients (73%) were mobilising without a stick. There were no major intra-operative complications and most (84%) patients rated the operation 'very good' at one year follow-up. We conclude that the posterior approach, already known to cause less blood loss and optimum component positioning, is compatible with a low overall rate of early complications especially dislocation.