One hundred fifty consecutive hybrid total hip arthroplasties in 139 patients were performed using an uncemented hemispheric porous coated acetabular component (HGP-I) with screws and a femoral component (Precoat) cemented with contemporary cementing technique. The average patient age was 67 years (range, 39-85 years). No patients were lost to followup. Eighty-six patients (91 hips) were alive for an average clinical followup of 103 months (range, 84-127 months); 81 hips had corresponding radiographic analysis. The average Harris hip score preoperatively was 47 points and increased to 88 points at followup. Ninety-five percent of patients had absent or slight pain. Aseptic loosening occurred in 2 femoral components (1.3%), 1 of which was revised for secondary osteolysis. Both hips had suboptimal cement mantles (C-2 or D grades). No femoral osteolysis was seen in stable components. Two acetabular components migrated; 1 secondary to preoperative irradiation osteonecrosis and 1 secondary to a bulk autogenous graft. Acetabular osteolysis without loosening developed in 2 patients (1.3%). Using revision and radiographic loosening as the end point, the probability of both components surviving 10 years was 96.9%, 98.6% for the acetabular component, and 98.4% for the femoral component. These results show that hybrid total hip arthroplasty offers excellent clinical function and exceptional 10-year survivorship.