At the recent meeting of the American Association of Hip and Knee Surgeons, a paper was presented comparing hip resurfacing with a metal-on-metal bearing to current large head total hip replacement using a metal-on-metal bearing. Review of the available data found that at an average 8.5 year follow-up the failure rate of the total hip replacement was 1.3% and that of the hip resurfacing was 2.6%. This higher rate of failure was at a shorter follow-up at 3.9 years. There was a symposium discussing the pros and cons of hip resurfacing and it was pointed out that hip resurfacing requires a larger incision and exposure and longer recovery, a higher incidence of groin pain and there was not a significant difference in range of motion between hip resurfacing and large head metal-on-metal hip replacement. There was no discernable difference in the ability to return to activities. It was noted that some of the anecdotal stories of return to higher activity levels are related to patient expectations who seek a hip resurfacing. There was consensus among the 700 members of the American Association of Hip and Knee Surgeons that the prevalence of hip resurfacing will most likely decline over the next several years. While enthusiasm is high at the present time, further objective data is required to determine if this is an operation that fulfills a necessary role.