One of the greatest technological advances in the history of medicine is the total joint replacement. Hip, knee, and shoulder replacements are routine throughout the world. They reduce pain in a cost-effective way and improve quality of life for millions of patients with end stage arthritis. Total hip replacement (THR) is considered a landmark surgery in modern medical history. The THR has developed with research and experimentation over the last 40–50 years with progressive improvement in materials used, fixation techniques, and peri-operative care. With improving life expectancy and increasing demand at a younger age, clinicians and scientists are always trying to find better performing implants to reduce the revision burden. This paper provides an up-to-date account of the relevant history of metal-on-metal (MoM) hips, problems associated with their use, current status, and guidance about how to continue surveillance of patients with MoM hip replacements.