The S-ROM-A femoral prosthesis (DePuy, Warsaw, IN) is a modular cementless femoral stem system that was developed to adapt to hip joint disorders of Asian patients. Clinical results of total hip arthroplasties using the S-ROM-A femoral prosthesis were evaluated in 68 hips. The average age at the time of surgery was 57.1 years. The mean follow-up period was 27.8 months. The Harris hip score improved from 47.1 points preoperatively to 91.4 points at final follow-up. No dislocations were observed. Implant fixation was good without any evidence of osteolysis or loosening. The S-ROM-A femoral prosthesis fitted well for Asian patients who often have osteoarthritis secondary to developmental dysplasia of the hip, by providing a shorter stem and greater variety in the neck shape of the stem with a smaller diameter.