INTRODUCTION A retrospective study was undertaken of a consecutive cohort of 86 patients (101 hips) under the age of 60 years operated on by a single orthopaedic team between 1993 and 2003 at a district general hospital. PATIENTS AND METHODS Demographic and diagnostic data were collected from patients' hospital records, and a detailed questionnaire regarding occupational status was used at follow-up. RESULTS Nearly all of the patients working prior to surgery returned to employment following surgery. Nearly half of those not working pre-operatively regained employment postoperatively; among those that did not return to work, this was for reasons unrelated to their hip. Those patients who had been out of work prior to their surgery took significantly longer to return to work. CONCLUSIONS Our study demonstrates that total hip replacement is effective in keeping patients under the age of 60 years employed. It is also effective in allowing those already off work due to hip pain to return to work, although there is a much greater delay.