The elbow joint is frequently affected by rheumatoid arthritis causing pain and disability which limits the use of the upper limb. Excisional or interpositional arthroplasties of the elbow have failed to provide satisfactory results. The design of a total elbow prosthesis in early 1970's followed the principles and evolution of joint replacement in the lower limb. In this study twenty-two Liverpool elbow prostheses (non-constrained) in nineteen patients were reviewed with an average follow-up of 26.5 months. Postoperatively the arc of flexion-extension improved with no change in pronation-supination range. Pain was significantly improved postoperatively. Rheumatoid patients were very pleased, but patients with secondary osteoarthritis were less satisfied. Two prostheses became loose and three had deep infection and were removed. Five patients had postoperative symptoms of ulnar neuritis and in three the symptoms gradually resolved. Early results of total elbow arthroplasty are promising in carefully selected patients.