Nineteen primary uncemented total hip arthroplasties (THAs) were performed in 15 patients with rheumatoid arthritis. Average age was 57.7 years. Four hips had an acetabular component placed with cement (Hybrid). The follow up period averaged 25.2 months (range, 6 to 61 months). Clinical evaluation based on the Japanese Orthopedic Association (JOA) score indicated significant improvement from preoperative to the most recent follow-up examination for pain. No hips required revision surgery. There was no evidence of roentgenographical failure; however, 68% of femoral and 73% of acetabular components had minor radiopaque lines and 53% of femoral components had cortical thinning in zones 2 and 6, and 74% of femoral components showed cortical atrophy in zones 1 and 7. No hips had femoral component subsidence, or acetabular component migration. Complications included only two dislocations. No deep sepsis occurred. These short term results suggest that cementless THA may be successful in rheumatoid hips. Clinical outcome is similar to that seen in our cemented THA paients, with a similar follow-up period. However, a longer follow-up study is necessary for a true evaluation of the efficacy of cementless THA in rheumatoid patients.