This is a retrospective study of 29 patients (34 hips) of Crowe grade IV dysplastic hips aged between 19 and 75 years who underwent THR for osteoarthritis secondary to DDH. The hips were evaluated radiologically for Sharp's acetabular angle, cup inclination, loosening, and ectopic bone formation. Clinically the results were evaluated by pre and postoperative -Harris hip scoring. The mean acetabular angle was 60.8° (range, 45°-68°) preoperatively. In 18 hips, subtrochanteric femoral osteotomy was performed. Pre-operatively, the mean leg length discrepancy was 5 cm (range, 2-8 cm). -Correction within 1 cm was possible in all patients -except in 4 patients. The mean Harris hip Score was 40.80 (32-45.90) preoperatively and 87.96 (74.78-94.72) at last follow-up. THR is successful in high dislocation dysplastic hips. Although there is no gold standard technique of THR in dysplastic hips and treatment of each patient should be individualized. Level of evidence : IV.