Computer assisted joint replacement surgery has been around for almost 10-years. This began in Europe and spread to the United States over 5-years ago. There has been quite a bit of enthusiasm regarding the benefits of computer assistance in joint replacement and several studies have been reported using this technique. We were part of a multi-center study that was completed in 2005. Our study, like most of those reported in the literature, showed that computer assisted surgery is safe, but at the present time it does not show a superior outcome with regard to pain relief and function in joint replacement surgery. There is a tendency toward fewer “outliers” with regard to the alignment of legs after knee replacement and improved cup placement in hip replacement. It however, has not been translated to improve functional outcomes and/or in the short-run better longevity. I remain encouraged by the early results of computer assisted surgery and believe that the software will continue to improve and make this a more practical application for joint replacement in the future. Until then, we continue to use this on selected cases. I believe that the software for computer assisted surgery will continue to improve and make this application more practical to the general orthopedist performing joint replacement surgery.