A retrospective study was conducted to determine the relative incidence and characteristics of the different forms of coxofemoral disease encountered in a hospital rheumatology clinic in Lomé (Togo). Hemoglobin electrophoresis was performed in all subjects included in the study. Of 2812 subjects examined over a 44-month period, 80, i.e. 2.8%, presented clinically and radiologically documented coxofemoral disease. Necrosis of the femoral head was the cause of coxofemoral disease in 36 subjects i.e. 45%, and was the most frequent etiology. In these 36 subjects hemoglobin was normal in 5 cases, type AS in 5, type AC in 1, type SS in 9, and type SC in 16. Coxarthrosis was detected in 31 subjects: either primary (n = 20) or secondary (n = 11). In this group, hemoglobin was normal in all but 3 subjects who exhibited type AS. The other etiologies observed were coxitis (n = 20) and epiphysitis (n = 3). This study documents the major role of hemoglobinopathy in the pathogenesis of coxofemoral disease in Black Africa. It confirms that AS and SC heterozygoses are not involved in the onset of aseptic necrosis.