The objective of this study was to perform a medium-term analysis comparing the clinical and radiographic outcomes of the CONSERVE® Plus (C+) and Birmingham Hip Resurfacing (BHR) arthroplasty systems. 137 hips were included in each cohort, with a mean follow-up of 60.0 ± 14.2 months and 63.3 ± 3.5 months in the C+ and BHR cohorts respectively. Latest review UCLA and HHS scores showed statistically significant improvements when compared with preoperative scores for both cohorts. UCLA and SF-12 physical component outcome scores were significantly different (p<0.01 and p = 0.04, respectively). Median serum chromium and cobalt levels were significantly increased in the BHR cohort (p = 0.001). Both cohorts demonstrated excellent Kaplan-Meier 5-year survival rates (96.9% in the C+ cohort, and 96.4% in the BHR cohort). Overall both implants appear to perform well in the medium term.