OBJECTIVE To summarize the clinical outcome of the Ribbed anatomic cementless total hip arthroplasty (THA) in the treatment of hip-joint disease. METHODS From January 2001 to June 2005, 34 patients (38 hips) with hip-joint disease were treated with Ribbed anatomic cementless THA. Their ages ranged from 29 to 55 years with an average age of 42.7 years. The disease course was from 3 to 18 years. Among these cases, there were 7 cases (7 hips) of femoral neck fracture, 5 cases (5 hips) of traumatic arthritis after fracture of acetabulum, 15 cases (16 hips) of necrosis of the femoral head and 7 cases (10 hips) of ankylosing spondylitis. Four patients were operated on both hip joints. The average Harris hip score was 38.6 (25-57) before operation. RESULTS Twenty-one patients(23 hips) were followed up 8-61 months with an average of 35 months. The Harris hip score was 76-98 after operation with an average of 92.3, showing significant difference when compared with that before operation (P < 0.05). The excellent and good result was achieved in 93.5% of patients. Radiographs showed no prosthetic osteolysis and no evidence of loosening. Pain in the thigh occurred in 4 patients,and it can be relieved by using non-steroid anti-inflammatory drug. CONCLUSIONS Ribbed anatomic cementless THA has good clinical and radiographic results in treating patients with hip-joint disease.