The purpose of total hip replacement is to relieve pain, not to make better athletes. Still, the modern patient is likely to return to recreation and sports. There is no current consensus on the safety of resuming athletics, though a surgeon’s judgment and a patient’s common sense will serve as appropriate guidelines. The main concerns are instability, wear, loosening, and fracture. Each sport should be evaluated on its potential risk to a joint replacement, whether from the force of repetitive injury or the possibility of catastrophic failure. Likewise, a surgeon can use techniques, biomaterials, and implants that will maximize an athlete’s chance of success over time.