Endoprosthetic proximal femur replacement is a well-accepted method for treatment of primary bone tumors; however the functional results of treatment are not well documented. To evaluate functional outcomes, we recorded the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society 1987 and 1993 scores in 29 patients, and also recorded Musculoskeletal Tumor Society scores alone in four more patients treated with endoprosthetic proximal femur replacement. The mean followup was 3 years. Twelve patients had a total hip endoprosthetic proximal femur replacement, and 21 had a bipolar hip endoprosthetic proximal femur replacement. In nine patients, the greater trochanter was attached to the femoral prosthesis. Sixteen patients had an abductor soft tissue repair, and in eight patients, no abductor repair was possible. The mean Musculoskeletal Tumor Society 1987 score was 23.2 +/- 4.1 points of 35 points. The mean Musculoskeletal Tumor Society 1993 score was 67.7 +/- 12.0%. The Toronto Extremity Salvage Score mean was 76.2 +/- 16.2 points of 100 points. Functional scores did not differ significantly between abductor repair types. There was a trend toward less disability in patients with abductor soft tissue repair compared with patients with no abductor repair. Functional results were similar in patients receiving bipolar and total hip replacements.