The long-term clinical and radiographic results of 38 Harris total hip replacements performed on 31 patients (average age, 50.7 years), with an average follow-up period of 11.5 years, were reviewed. According to a modified d'Aubigne-Postel hip rating system, 14 hips were rated excellent, 19 good, 4 fair, and 1 poor. Only one patient had revision surgery for symptomatic acetabular and femoral loosening. Eight acetabular components migrated, usually after 10 years; this did not correlate with an unsatisfactory clinical result, except in one hip. There was subsidence or loosening of the femoral component in five hips, usually associated with a technical error or severe calcar resorption; this occurred early and did correlate with an unsatisfactory clinical result. Clinical results were satisfactory in 86% of the hips with long-term follow-up study. However, radiographic failure occurred in 34% of the hips, with a predominance of late acetabular migration.